The Problem with Futility

Abstract

...The notion of futility generally fails to provide an ethically\ncoherent ground for limiting life-sustaining treatment, except in\ncircumstances in which narrowly defined physiologic futility can be plausibly\ninvoked. Futility has been conceptualized as an objecitve entity independent\nof the patient's or surrogate's perspective, but differences in values and the\nvariable probabilities of clinical outcomes undermine its basis. Furthermore,\nassertions of futility may camouflage judgments of comparative worth that are\nimplicit in debates about the allocation of resources. In short, the problem\nwith futility is that its promise of objectivity can rarely be fulfilled. The\nrapid advance of the language of futility into the jargon of bioethics should\nbe followed by an equally rapid retreat.