More recently the medical literature has centred on the limits of treatment. The term is vaguely defined and often misused. Futility has wrongly been regarded as objective when, in fact, it is heavily value-laden.
Treatment is only futile according to somebody's opinion when compared to some alternative.
It allows patients to refuse even low risk life-saving treatment. Futility has both qualitative and quantitative aspects which independently may determine whether treatment should be offered or withheld, but usually the situation also involves great uncertainty. Futility is a judgement that treatment is not beneficial but, in practice we must also consider the possibility of causing harm through pain, suffering, risks of prolonged ventilator dependence, persistent vegetative state, etc. These effects of treatment bring us into the area of burden versus benefit as part of a continuum with futility. We should never use the claim of futility to justify rationing of resources.