Medical futility policies are an unwarranted return to the paternalistic system, Smith said. It s reintroducing the game of Doctor Knows Best. It s not humane or compassionate to provide painful procedures when there can t be a benefit. Campbell helped write her facility s guidelines for nonbeneficial treatment. Though the plan has been in place since 1995, Campbell estimates clinicians get to the point of deciding whether to override a patient s or surrogate s wishes only two or three times a year.
Some policies outline a process for dealing with disputes rather than actually defining futility .
That s the case at Hermann Hospital in Houston, which last year adapted the Houston City-Wide Guidelines on Medical Futility for its own use. Hermann hasn t invoked its policy yet, but the staff came close once, said Ginny Gremillion, director of patient relations. With the family s consent, life support was removed and the patient died. It s called pressuring the patient to do what the doctor wants. The most vulnerable, he said, are the elderly and those with pre-existing disabilities.