Saturday, October 1, 2011
Futile Treatment?
An elderly patient has been steadily deteriorating with a number of chronic medical conditions, including kidney failure. She is now in crisis mode, and requires a surgical procedure with low chance of success in order to survive. Even if the procedure works, she will surely die within six months due to her other conditions, and will not be able to leave the hospital or a hospice. There are conflicting assessments of the patient's decision making capacity, and she doesn’t seem to express much of a preference for or against the surgical procedure. Her family wants the procedure. Should the care team perform the procedure?
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This scenario falls under the concept of normative futile treatment, according to the legal terms of futile care the treatment team does not have to provide the procedure. Ideally the doctors could educate the family on the expense of ICU care and how the effects of the procedure will not help in the long run. However, despite all of this the treatment team does not have to provide any treatment regardless of the family’s wishes if the treatment falls under the terms of futile, which in this case it does.
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