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Pipes, Colanders, and Leaky Buckets: Reflections on the Futility Debate

Published online by Cambridge University Press:  29 July 2009

John J. Paris
John J. Paris
Affiliation:
Michael P. Walsh Professor of Bioethics at Boston College, Professor of Community Health at Tufts University School of Medicine, and Adjunct Professor of Medicine at the University of Massachusetts Medical School
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Extract

The issue of physician refusal of requested treatment has fueled a two-pronged debate in our society-one on the meaning of futility and the other on the limits of patient autonomy. The latter is a genuinely philosophic dispute; the former, it seems, is a modern relapse into nominalism.

It is not the meaning of a word, but the moral basis for the actions of the par-ticipants that should be the focus of our attention, Yet the medical literature distracts us with articles titled “Medical Futility: Its Meaning and Ethical Implica-tions” “The Problem with Futility” “Who Defines Futility?,” “The Illusion of Futility,” and even “Beyond Futility.”

The history of the futility debate, which was launched by a 1983 study of Bedell and Delbanco that demonstrated the ineffectiveness of CPR for certain catego-ries of patients, has been documented elsewhere. Here we will inquire if the term, and its rapid intrusion into the medical lexicon, serves a useful purpose or if, as Truog suggested, we would all be better off if this new buzzword were jettisoned.

Type
Special Section: Medical Futility: Demands, Duties, and Dilemmas
Information
Cambridge Quarterly of Healthcare Ethics , Volume 2 , Issue 2 , Spring 1993 , pp. 147 - 149
Copyright
Copyright © Cambridge University Press 1993

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References

Notes

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13. 1992. Article 8 ss 54.1–2990. Ch. 29 of the Code of Virginia.

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