Medical Futility: And the Evaluation of Life-Sustaining Interventions

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This book surveys the clinical, ethical, religious, legal, economic and personal dimensions of decision making in situations when the choice is between extending costly medical treatment of uncertain effectiveness, or terminating treatment thereby ending the patient's life. Contributors from various disciplines offer perspectives on issues ranging from the definition of medical futility to the implications for care in various clinical settings. Medical Futility will be obligatory reading for health care ...
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Overview

This book surveys the clinical, ethical, religious, legal, economic and personal dimensions of decision making in situations when the choice is between extending costly medical treatment of uncertain effectiveness, or terminating treatment thereby ending the patient's life. Contributors from various disciplines offer perspectives on issues ranging from the definition of medical futility to the implications for care in various clinical settings. Medical Futility will be obligatory reading for health care professionals, students and scholars concerned with ethical standards in medical care.

The book contains no figures.

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Editorial Reviews

Nancy S. Jecker
The 16 chapters of this book are prepared by scholars from diverse disciplinary perspectives, including psychiatry, pediatrics, family medicine, nursing, philosophy, theology, social work, law, and business. The editors are Marjorie B. Zucker, a retired scientist affiliated with Choice in Dying and Howard Zucker, an Associate Clinical Professor Emeritus of Psychiatry and Medicine at Mount Sinai Medical Center. The book encompasses four main topics. First, it addresses the application of medical futility to diverse healthcare settings and patient populations. Second, it considers a range of cultural, religious, and psychological aspects of medical futility. Third, contributors explore the proper roles for ethics committees, courts, healthcare professionals, the community, and healthcare institutions in defining standards for medical futility. The final section of the book warns readers about potential abuses of medical futility. The purpose is to provide diverse perspectives on the definition and ethical implications of medical futility in a variety of clinical contexts, including acute care, general medicine, pediatric, and nursing home settings. With its combination of theoretical and clinical topics, bioethicists and healthcare professionals will find this book useful. The book is accessible to students of medicine, law, nursing, and ethics and could serve as a supplementary text for bioethics courses. The book underscores the variety of clinical contexts to which medical futility is applied and stresses the importance of distinguishing between medical futility and decisions about health care rationing. It encourages building safeguards into decision-making processes to ensurecareful and accurate futility assessments. This book provides a balanced, cross-disciplinary approach to the controversial topic of medical futility. It shows the importance of taking into account the influence of clinical context, cultural and religious perspectives, psychosocial dimensions, and economic factors.
From the Publisher
'The conflict between patients' automony and choice and professionals' decision making is at the core of Medical Futility … It analyses care at the end of life in cultural, religious, and ethical contexts, as well as the economic consequences of providing treatments that are of little benefit at this, or indeed, any, time.' Alex Paton, British Medical Journal

'For those wishing for insight it will provide food for thought.' Gina Agarwal, The Lancet

' … useful contribution to the public debate.' Journal of the Royal Society of Medicine

'The 25 contributors, 10 from disciplines other than medicine, address with authority a range of issues associated with the concept of medical futility in various clinical settings … The message of hope from this though-provoking book is that conflict can be avoided in most cases by good communication between doctor and patient and the exercise of common sense.' Neuroradiology 40

'A valuable contribution to a subject of immense practical importance and warmly recommended.' John Saunders, Journal of Medical Ethics

' … a compact treatment of a complex subject … a very accessible book, clearly written and easy to read … a good introduction … a good, basic introduction to an important topic in bioethics.' The New England Journal of Medicine

Doody's Review Service
Reviewer: Nancy S. Jecker, PhD (University of Washington School of Medicine)
Description: The 16 chapters of this book are prepared by scholars from diverse disciplinary perspectives, including psychiatry, pediatrics, family medicine, nursing, philosophy, theology, social work, law, and business. The editors are Marjorie B. Zucker, a retired scientist affiliated with Choice in Dying and Howard Zucker, an Associate Clinical Professor Emeritus of Psychiatry and Medicine at Mount Sinai Medical Center. The book encompasses four main topics. First, it addresses the application of medical futility to diverse healthcare settings and patient populations. Second, it considers a range of cultural, religious, and psychological aspects of medical futility. Third, contributors explore the proper roles for ethics committees, courts, healthcare professionals, the community, and healthcare institutions in defining standards for medical futility. The final section of the book warns readers about potential abuses of medical futility.
Purpose: The purpose is to provide diverse perspectives on the definition and ethical implications of medical futility in a variety of clinical contexts, including acute care, general medicine, pediatric, and nursing home settings.
Audience: With its combination of theoretical and clinical topics, bioethicists and healthcare professionals will find this book useful. The book is accessible to students of medicine, law, nursing, and ethics and could serve as a supplementary text for bioethics courses.
Features: The book underscores the variety of clinical contexts to which medical futility is applied and stresses the importance of distinguishing between medical futility and decisions about health care rationing. It encourages building safeguards into decision-making processes to ensure careful and accurate futility assessments.
Assessment: This book provides a balanced, cross-disciplinary approach to the controversial topic of medical futility. It shows the importance of taking into account the influence of clinical context, cultural and religious perspectives, psychosocial dimensions, and economic factors.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780521560207
  • Publisher: Cambridge University Press
  • Publication date: 3/13/1997
  • Pages: 219
  • Product dimensions: 5.98 (w) x 8.98 (h) x 0.67 (d)

Table of Contents

Preface
Foreword
Contributors
1 Medical futility: a useful concept? 1
2 Death with dignity? 15
3 Physicians and medical futility: experience in the critical care setting 24
4 Physicians and medical futility: experience in the setting of general medical care 36
5 Futility issues in pediatrics 48
6 Medical futility: a nursing home perspective 58
7 Alternative medicine and medical futility 65
8 How culture and religion affect attitudes toward medical futility 71
9 When religious beliefs and medical judgments conflict: civic polity and the social good 85
10 Conflict resolution: experience of consultation-liaison psychiatrists 98
11 Ethics committees and end-of-life decision making 110
12 The economics of futile interventions 123
13 Medical futility: a legal perspective 136
14 Professional and public community projects for developing medical futility guidelines 155
15 Community futility policies: the illusion of consensus? 168
16 Not quite the last word: scenarios and solutions 179
Index of cited authors, cases, and statutes 193
Subject index 198
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