“The term medical futility has become a shorthand way to describe a situation in which the patient demands and the physician objects to the provision of certain medical treatment on the ground that the treatment will provide no medical benefit to the patient” (Daar 1995:221). The debate on the issue of medical futility has focused primarily on the care and treatment provided in the acute care setting. But questions about how medical futility decisions are reached also have profound implications for nursing homes, the institutions created to care for the oldest and most vulnerable of our society.

Discussion of what may be considered medically futile treatment goes to the heart of what it means to provide care and treatment for the dependent elderly, how we define and value life, and how we view the role of medical technology. These considerations define the role of the nursing home as a care-giving institution. How do we as a society create the kind of environment that will allow us to number our days in comfort and dignity while dealing with the difficult decisions that medical technology has foisted upon us? A number of factors may influence the manner in which the issue of medical futility is explored and resolved in the nursing home.

The role of nursing homes

As institutions, nursing homes are challenged to both care and cure.