Advance Directives, Due Process, and Medical Futility
Authors: Jeffrey T. Berger
Journal: Annals of Internal Medicine (2004)

Letters2 March 2004Advance Directives, Due Process, and Medical FutilityJeffrey T. Berger, MDJeffrey T. Berger, MDFrom Winthrop-University Hospital, Mineola, NY 11501.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-5-200403020-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Fine and Mayo (1) describe an ethical–judicial process for resolving disputes about determinations of futility. While these novel and sorely needed efforts are laudable, conceptual and pragmatic issues remain. Conceptually, the use of the term futile is increasingly understood as defying meaningful and clinically useful definition (2). The article's opening case description demonstrates this murky thinking: Although the patient could have been kept alive “many months or more in the ICU [intensive care unit] but would not survive outside it,” the team determined that treatment was considered futile. However, this determination is far from uniform among physicians ...References1. Fine RL, Mayo TW. Resolution of futility by due process: early experience with the Texas Advance Directives Act. Ann Intern Med. 2003;138:743-6. [PMID: 12729429] LinkGoogle Scholar2. Council on Ethical and Judicial Affairs. American Medical Association. Code of Medical Ethics. Chicago: American Medical Association; 1997. Google Scholar3. Hanson LC, Danis M, Garrett JM, Mutran E. Who decides? Physicians' willingness to use life-sustaining treatment. Arch Intern Med. 1996;156:785-9. [PMID: 8615712] CrossrefMedlineGoogle Scholar4. Fox E. Ethics Consultation in U.S. Hospitals: National Survey and Its Implications. Baltimore, MD: American Society for Bioethics and Humanities Fifth Annual Meeting; 24 October 2002. Google Scholar5. Berger JT, Rosner F, Potash J, Kark P, Farnsworth P, Bennett AJ. Medical futility: towards consensus on disagreement. HEC Forum. 1998;10:102-18. [PMID: 10178379] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jeffrey T. Berger, MDAffiliations: From Winthrop-University Hospital, Mineola, NY 11501. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoResolution of Futility by Due Process: Early Experience with the Texas Advance Directives Act Robert L. Fine and Thomas Wm. Mayo Advance Directives, Due Process, and Medical Futility Thomas E. Finucane Advance Directives, Due Process, and Medical Futility Anne L. Flamm and Martin L. Smith Advance Directives, Due Process, and Medical Futility Robert L. Fine and Thomas Wm. Mayo Metrics Cited byExtending palliative care to patients with heart failureExtremely Long Hospitalizations of Newborns in the United StatesExtremely long hospitalizations of newborns in the United States: Data, descriptions, dilemmas 2 March 2004Volume 140, Issue 5Page: 402-403KeywordsFallsIntensive care units ePublished: 2 March 2004 Issue Published: 2 March 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...