Showing 6 results for Futility
Mansureh Madani,
Volume 6, Issue 2 (5-2013)
Abstract
When medical treatment is futile, the physicians must refrain from treating patients, and this can lead to serious and stressful problems. In this paper, in order to facilitate ethical decision making relevant literatures have been reviewed. This review article aimed to explaining the different clinical forms of futile treatment, and exploring theoretical and practical dimensions of futility. The first problem in this field is ambiguity in the definition of futility. The next problem is determining the practical criteria and attributing the meaning of futility to particular treatments. This ambiguity is partly due to different perspectives about the goal of treatment, and variations in physicians' and patients’ values and also disagreements regarding the person who should have the right to make decisions ultimately. It may also be related to finances and immoral motives. The third problem is some practical conflicts the most notable are futile care, requested by the patient and the sanctity of life, especially in the concern of religious considerations. In this regard, several definitions have been proposed for the futile treatment. Studies indicate that requesting futile care is often due to emotional problems or lack of trust a case that requires the physician’s tact to resolve and rarely is resolved by rule. Another serious problem that is regarding to end of life cares, especially in the context of religious views, is the necessity of life saving, that is closely related to the inactive euthanasia. This can be solved by giving priority to more important issues such as health budget constraints.
Saeedeh Saeedi Tehrani1, Mansoureh Madani,
Volume 7, Issue 6 (3-2015)
Abstract
Medical futility refers to diagnostic, treatment, and rehabilitation interventions that are unlikely to produce any positive outcome for patients. Doctors should beware of such actions due to their professional commitments. There are ambiguities in the definition of futility that have been the subject of many studies. In this paper, relevant literature was reviewed to find a definition for futility from the perspective of the four bioethical principles.Determining the futility of an action, whether it is the request of the patient, their family or service providers, is a highly sensitive matter that can lead to unethical decisions in the medical profession.Autonomy is a concept that is related to the diverse views on treatment objectives. In this paper we investigated the issues of physician and patient autonomy, and the differences between the values of the people involved. We have also discussed the concept of palliative care with an attempt to clarify the difference between this type of care and futile care, and to determine the boundaries. Another focus of our study was situations where physicians and other health care providers deliver futile treatment for various purposes. Such cases involve factors that may influence the judgment of physicians, and some of them are unethical due to incentives such as financial gain.Finally, ethical decision-making in this area is only possible through clarification of the different aspects of the issue and prioritization by experts and professionals. In order to do so, all circumstances need to be taken into account, including allocation of scarce resources within the health care system and fairness. Moreover, medical staff should have access to the necessary information so that they can make ethical decisions in different situations.
Amirahmad Shojaei,
Volume 9, Issue 6 (3-2017)
Abstract
Although, physicians have a duty to treat their patients, sometimes the cure is not possible in medicine and there is no result in attempt to cure patient. In this situation, we face with two types of patients: first, patients who are conscious but suffering with advanced disease and will survive only for a short time. The second group, are patients who are unconscious and may not be cured with the standard treatment based on physician experience.
The latter are the subject of the present article. So what a Hospital should do in dealing with these patients? How the hospital, should develop a community-based policy on providing care for these patients. Finally, how should inform the public to adhere to these policies.
Mohsen Rezaei Aderyani, Saeid Nazari Tavakkoli, Mehrzad Kiani, Mahmood Abbasi, Mohsen Javadi,
Volume 10, Issue 0 (3-2017)
Abstract
Medical ethics is an old science. Some of its issues have historical precedence, and others are modern challenges, and have emerged with advances in technology. One of such historic but newly emerging challenges is "bi’natijeghi-e-pezeshki (futile treatment)", which is defined as the treatment that cannot achieve its goal. This term entered medical literature as "medical futility" in late 1980s. Based on this investigation, it can be concluded that this term should only be used when the desired outcome following medical procedure and the outcome sought by the medical team and patient/family (patient's health) is unlikely to be realized. There are various equivalents for this term in our country (Islamic Republic of Iran), including "bi’fayedegi-e-pezeshki (medical uselessness)", "bi’houdeghi (frivolity) in medicine", and even "inappropriate treatment". The present article aimed to find a suitable Persian equivalent for this concept. The use of interpretations such as "frivolity" or "uselessness" may cause misunderstanding between patient/family and the medical team, and can ruin the trust between patient/family and the medical team. Thus, the best alternative to this English term appears to be "bi’natijeghi-e-pezeshki (futile treatment)".
Mohammad Hossein Asgardoon, Sepehr Azizi, Azin Ebrahimi, Mohammad Hossein Ahmadian,
Volume 12, Issue 0 (3-2019)
Abstract
Several definitions for medical futility has been proposed in the literature. Medical futility is defined as the condition in which an intervention, either for diagnosis, prevention, treatment, rehabilitation or other medical goals, has no benefit for the individual patient. This critical review aimed to increase the understanding of physicians and other healthcare providers on the issue of futility in complementary and alternative medicine (CAM). Our comprehensive search resulted in more than 1000 studies; unrelated studies were excluded by title and abstract screening, then 219 full-texts were read and finally, 118 studies were included. The conclusion concerning whether or not it is morally acceptable to provide a futile treatment in CAM, becomes a controversial issue based on different approaches. Using futile treatments is not acceptable according to the duty-based approach, and the principle of justice. In contrast, the case-based approach and the principle of autonomy of the patient, hold that such treatments could be morally acceptable. Based on utilitarianism, only evidence-based treatments can be morally discussed, and those CAM therapies that have been shown to be futile, should be prohibited; thus health care providers must not offer them to patients since it would be a kind of deceit. We suggest that more comprehensive studies should be performed to clarify the boundary between placebo, nocebo, and futility.
Saeed Nazari Tavakkoli, Saeed Ghadirzadeh Toosi,
Volume 17, Issue 1 (3-2024)
Abstract
Treating patients whose lives are in danger or threatened by irreparable harm, is an obligatory act. However, sometimes, due to old age, the severity of the disease, or the lack of definitive treatment, the patient faces a situation where, according to the diagnosis of the medical staff, starting or continuing the treatment has no effect on patient recovery, or the effect is so insignificant that is ignored in medical practice. This study was conducted using a descriptive and analytical method based on library resources to compare “futile treatment” in medical ethics with “Israf” (extravagance) in Islamic jurisprudence so as to indicate the level of conceptual compatibility between these two concepts. Moreover, considering the illegitimacy of extravagance in jurisprudential teachings, it was attempted to explore whether it is illegitimate, according to Islamic rules, to perform futile treatment. To do so, first, futile treatment and its characteristics in medical texts were defined. Second, the ethical considerations of performing such treatment were explained based on the teachings of medical ethics. Third, extravagance was analyzed in terms of concept, topic, and sentence by referring to valid lexical, jurisprudential, narrative, and interpretative resources. Finally, based on a comparative study, the level of compatibility of futile treatment with extravagance was investigated. The findings of this study showed futile treatment is an example of extravagance as it causes the waste of personal or public property, lacks rational purpose, and does not lead to patient recovery or promotion of health status. Therefore, futile treatment is not considered an obligatory act but even an illegitimate one as it is a clear example of extravagance. In addition to punishment in the afterlife, it entails civil liability as it results in the loss of others’ property.
