Deciding that treatment is futile can have irreversible consequences. Because it determines the course of further care for the patient, determining futility is one of the most important decisions that can be made at the end of life. It is the attending physician's responsibility to make a determination of futility. Since this is such an important decision, it must be made after considering all treatment options, discussing with members of the health care team, and considering the patient's and the family's wishes. The medical ethics committee at the hospital is also available to assist the health care team and family in the process of determining futility.
Competent patients have the right to refuse life-sustaining treatment.
When the primary goal shifts from restoring health and prolonging life to making the patient comfortable throughout the dying process, withdrawing treatment may become an option. Withdrawing treatment, however, is not the same as withdrawing care. Pain control and comfort care can never be withdrawn or withheld. The decision to withdraw therapy requires the same open communication as that involved in initiating or continuing life-sustaining treatment. Think about what you really want to have happen, given your medical condition and your family situation.