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  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
  • More About:

  • Hospice Care
  • Clergy and Faith Communities
  • Additional Links
    Site Index
    Back to Module 9: Medical Futility
    Important Questions about Medical Futility

    Important Questions about Medical Futility

    Important Questions about Medical Futility

    Physicians and Futility

    • Patients/families invested in interventions
    • Physicians/other professionals invested in interventions (less commonly acknowledged)
    • Inclination to intervene
      • Maintain hope
      • Belief that the physician's job is to maintain life at all costs
      • Avoid shame or sense of failure
      • Need to feel that "everything possible" was done
      • Assurance of no guilt after death of patient
    • Any party may perceive futility


    Patient-Centered Care

    • "Who are we doing this for?" fundamental question
    • Patient's goals and values critical
    • Resolution of differences in goals showing respect
      • Health professionals' expertise and knowledge
      • Centrality of the patient


    Conflict over Treatment

    • Unresolved conflicts lead to misery
    • Most conflicts can be resolved through...
      • Communication
      • Compassion
      • Empathy
    • Try to understand and resolve differences--physician's obligation and role
      • Support patient and family, and relieve suffering
      • Understand and resolve differences in perception about treatment
    • Most disagreements about futile care are result of:
      • Misunderstandings

      • Lack of physician attention to the family's or physician's emotional reaction to the patient's dying
    • Critical issue: understand why there is disagreement
    • Conflicts can often be resolved in a way that is respectful of the patient/family and physician
    • Focus on understanding points of view will help with bereavement
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