Odds and Ends: Trust and the Debate over Medical Futility
Authors: Arthur L. Caplan
Journal: Annals of Internal Medicine (1996)

Editorials15 October 1996Odds and Ends: Trust and the Debate over Medical FutilityArthur L. Caplan, PhDArthur L. Caplan, PhDUniversity of Pennsylvania, Philadelphia, PA 19104Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-8-199610150-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Much of what passes for methodology in bioethics goes by the name of conceptual analysis. Or, to put it another way, bioethicists spend much of their time arguing about the precise meanings of words. Persons who do not have the temperament or the patience for such verbal dissection use less flattering, albeit more colorful, descriptions, in which images of heads located in clouds or dances done on the head of a pin (or worse) loom large. The ongoing wrangling about the concept of medical futility [1] is a perfect example of why some find bioethics valuable and others do not.... References1. Misbin RE, Jennings B, Orentlicher D, Dewar M, eds. Health Care Crisis? Frederick, MD: Univ Publishing; 1995. Google Scholar2. Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: its meaning and ethical implications. Ann Intern Med. 1990; 112:949-54. Google Scholar3. Schneiderman LJ, Jecker NS. Wrong Medicine: Doctors, Patients and Futile Treatment. Baltimore: Johns Hopkins Univ Pr; 1995. Google Scholar4. Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: response to critiques. Ann Intern Med. 1996; 125:669-74. Google Scholar5. Rubenfeld GD, Crawford SW. Withdrawing life support from mechanically ventilated recipients of bone marrow transplants: a case for evidence-based guidelines. Ann Intern Med. 1996; 125:625-33. Google Scholar6. Faber-Langendoen K, Caplan AL, McGlave PB. Survival of adult bone marrow transplant patients receiving mechanical ventilation: a case for restricted use. Bone Marrow Transplant. 1993; 12:501-7. Google Scholar7. Christakis NA, Asch DA. Biases in how physicians choose to withdraw life support. Lancet. 1993; 342:642-6. Google Scholar8. Halevy A, Brody BA. A multi-institution collaborative policy on medical futility. JAMA. 1996; 276:571-4. Google Scholar9. Truog RD, Brett AS, Frader J. The problem with futility. N Engl J Med. 1992; 326:1560-4. Google Scholar10. Identifying Health Technologies That Work: Searching for Evidence. Washington, DC: Office of Technology Assessment, Congress of the United States; 1994. Google Scholar11. Caplan AL. Moral Matters: Ethical Issues In Medicine and the Life Sciences. New York: Wiley; 1995. Google Scholar12. Witzig R. The medicalization of race: scientific legitimization of a flawed social construct. Ann Intern Med. 1996; 125:675-9. Google Scholar13. Connors RB, Smith ML. Religious insistence on medical treatment: Christian theology and re-imagination. Hastings Cent Rep. 1996; 26:23-30. Google Scholar14. Caplan AL. The ethics of gate keeping in rehabilitation medicine. Journal of Head Rehabilitation Trauma. 1996; [In press]. Google Scholar15. Caplan AL. The ethical implications of the corporatization of American health care. In: Baer ED, Fagin CM, Gordon S, eds. Abandonment of the Patient: The lmpact of Profit-Driven Health Care on the Public. New York: Springer; 1996. Google Scholar16. Mechanic D, Schlesinger M. The impact of managed care on patients' trust in medical care and their physicians. JAMA. 1996; 275:1693-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania, Philadelphia, PA 19104Corresponding Author: Arthur L. Caplan, PhD, Center for Bioethics, University of Pennsylvania, 3401 Market Street, Room 320, Philadelphia, PA 19104. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMedical Futility: Response to Critiques Lawrence J. Schneiderman , Nancy S. Jecker , and Albert R. Jonsen Withdrawing Life Support from Mechanically Ventilated Recipients of Bone Marrow Transplants: A Case for Evidence-Based Guidelines Gordon D. Rubenfeld and Stephen W. Crawford The Medicalization of Race: Scientific Legitimization of a Flawed Social Construct Ritchie Witzig Metrics Cited ByTraditional and Applied Clinical Ethics: Contemporary and Evolving ChallengesFrühgeborene an der Grenze der Lebensfähigkeit (Entwicklungsstufe S2k, AWMF-Leitlinien-Register Nr. 024/019, Juni 2020)Medical Futility: When Further Therapy Is HopelessFutility in RehabilitationFutility Disputes: A Review of the Literature and Proposed Model for Dispute Navigation Through Trust BuildingTrust and Mistrust Between Patients and DoctorsQuality end-of-Life cancer care: An overdue imperativeTrust and Mistrust Between Patients and DoctorsEnd of Life/Palliative Care/EthicsEthical IssuesA Prognostic Index for Survival among Mechanically Ventilated Hematopoietic Cell Transplant RecipientsOutcome in critically ill patients with allogeneic BM or peripheral haematopoietic SCT: a single-centre experienceEnd-of-Life Decision Making in the ICUEnd-of-Life Decision Making in the Intensive Care UnitEthical Principles—Emergency MedicineMedical futilityTopical discussionIdentification of poor prognostic features among patients requiring mechanical ventilation after hematopoietic stem cell transplantationUnilateral withdrawal of life-sustaining therapy: Is it time? Are we ready?Ethics Seminars:Case Studies in "Futility"-Challenges for Academic Emergency MedicineDetermination of "futility" in emergency medicineShould a patient in persistent vegetative state live?De facto health‐care rationing by ageAn ethical dilemma in anaesthetic practice: when the anaesthetist believes surgery to be futileAccidents vasculaires cérébraux et indications de réanimation : aspects éthiquesOutcomes Research in the ICU Setting 15 October 1996Volume 125, Issue 8Page: 688-689KeywordsBioethicsHealth care providersInformation technologyIntensive care unitsMortalityPalliative carePatient advocacyPatientsRacial and ethnic issuesVentilators Issue Published: 15 October 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...