CE: “Medically futile” treatments require more than going to court

With the unrelenting development of new medical technologies and increasingly more complex treatments, health-care providers sometimes find themselves faced with requests to provide treatments they believe to be medically futile. This language and resulting argument based on it can produce an adversarial posturing on the part of providers and families that frequently anticipates or threatens a legal solution. Although our legal system will choose sides on an issue, futility cases that have ended up in the courts have generally failed to definitively answer questions about how to address future dilemmas. A more helpful process is a clear procedure for addressing both sides of the question with the ultimate decision-making remaining within the health-care setting. The ethically appropriate solution lies within the context of a shared decision-making process between patient/family and physician/health-care provider that honors the values of both parties without assuming a unilateral decision-making stance. Case managers and direct-care providers, when faced with requests for treatments deemed to be medically inappropriate or futile, are challenged to understand and pursue this shared process.