Medical Futility: And the Evaluation of Life-Sustaining Interventions / Edition 1

by Marjorie B. Zucker, Howard D. Zucker, Alexander Morgan Capron

Overview

This volume surveys the clinical, ethical, religious, legal, economic, and personal dimensions of decision making in situations when the choice is either to extend costly medical treatment of uncertain effectiveness, or to terminate treatment, thereby ending the patient's life. Contributors from a wide range of disciplines offer perspectives on issues ranging from the definition of medical futility to the implications for care in various clinical settings, including intensive care, neonatal and pediatric practice and nursing homes. An important contribution toward the more humane and consistent handling of these situations, Medical Futility will be obligatory reading for health care professionals, students, and scholars concerned with ethical standards in medical care.

Product Details

ISBN-13:	9780521568777
Publisher:	Cambridge University Press
Publication date:	03/13/1997
Edition description:	New Edition
Pages:	220
Product dimensions:	5.94(w) x 9.02(h) x 0.55(d)

About the Author

Zucker, Marjorie B. (Choice In Dying, New York); Zucker, Howard D. (Mount Sinai School of Medicine)

The contributors represent the specialties of bioethics, psychiatry, and pediatrics. Most are from U.S. universities and medical centers, including Univ of Pennsylvania, Univ of Pittsburgh, Mt. Sinai Medical Center, and Midwest Bioethics Center.

Table of Contents

Preface; Foreword Alexander Morgan Capron; Contributors; 1. Medical futility: a useful concept? Howard Brody; 2. Death with dignity Patricia Brophy; 3. Physicians and medical futility: experience in the critical care setting Harry S. Rafkin and Thomas Rainey; 4. Physicians and medical futility: experience in the setting of general medical care Norton Spritz; 5. Futility issues in pediatrics Joel E. Frader and Jon Watchko; 6. Medical futility: a nusing home perspective Ellen Knapik Bartoldus; 7. Alternative medicine and medical futility Joseph J. Jacobs; 8. How culture and religion affect attitudes toward medical futility Mary F. Morrison and Sarah Gelbach DeMichele; 9. When religious views and medical judgements conflict: civic polity and the social good John J. Paris and Mark Poorman; 10. Conflict resolution: experience of consultation-liaison psychiatrists James J. Strain, Stephen L. Snyder and Martin Drooker; 11. Ethics committees and end of life decision making Alice Herb and Eliot J. Lazar; 12. The economics of futile interventions Donald J. Murphy; 13. Medical futility: a legal perspective William Prip and Anna Moretti; 14. Professional and public community projects for developing medical futility guidelines Linda Johnson and Robert Lyman Potter; 15. Community futility policies: the illusion of consensus? Bethany Spielman; 16. Not quite the last word: scenarios and solutions Karen Orloff Kaplan; Indexes.

Editorial Reviews

Reviewer: Nancy S. Jecker, PhD (University of Washington School of Medicine)
Description: The 16 chapters of this book are prepared by scholars from diverse disciplinary perspectives, including psychiatry, pediatrics, family medicine, nursing, philosophy, theology, social work, law, and business. The editors are Marjorie B. Zucker, a retired scientist affiliated with Choice in Dying and Howard Zucker, an Associate Clinical Professor Emeritus of Psychiatry and Medicine at Mount Sinai Medical Center. The book encompasses four main topics. First, it addresses the application of medical futility to diverse healthcare settings and patient populations. Second, it considers a range of cultural, religious, and psychological aspects of medical futility. Third, contributors explore the proper roles for ethics committees, courts, healthcare professionals, the community, and healthcare institutions in defining standards for medical futility. The final section of the book warns readers about potential abuses of medical futility.
Purpose: The purpose is to provide diverse perspectives on the definition and ethical implications of medical futility in a variety of clinical contexts, including acute care, general medicine, pediatric, and nursing home settings.
Audience: With its combination of theoretical and clinical topics, bioethicists and healthcare professionals will find this book useful. The book is accessible to students of medicine, law, nursing, and ethics and could serve as a supplementary text for bioethics courses.
Features: The book underscores the variety of clinical contexts to which medical futility is applied and stresses the importance of distinguishing between medical futility and decisions about health care rationing. It encourages building safeguards into decision-making processes to ensure careful and accurate futility assessments.
Assessment: This book provides a balanced, cross-disciplinary approach to the controversial topic of medical futility. It shows the importance of taking into account the influence of clinical context, cultural and religious perspectives, psychosocial dimensions, and economic factors.

Doody's Review Service

'The conflict between patients' automony and choice and professionals' decision making is at the core of Medical Futility … It analyses care at the end of life in cultural, religious, and ethical contexts, as well as the economic consequences of providing treatments that are of little benefit at this, or indeed, any, time.' Alex Paton, British Medical Journal

'For those wishing for insight it will provide food for thought.' Gina Agarwal, The Lancet

' … useful contribution to the public debate.' Journal of the Royal Society of Medicine

'The 25 contributors, 10 from disciplines other than medicine, address with authority a range of issues associated with the concept of medical futility in various clinical settings … The message of hope from this though-provoking book is that conflict can be avoided in most cases by good communication between doctor and patient and the exercise of common sense.' Neuroradiology 40

'A valuable contribution to a subject of immense practical importance and warmly recommended.' John Saunders, Journal of Medical Ethics

' … a compact treatment of a complex subject … a very accessible book, clearly written and easy to read … a good introduction … a good, basic introduction to an important topic in bioethics.' The New England Journal of Medicine

From the Publisher

4 Stars! from Doody

The 16 chapters of this book are prepared by scholars from diverse disciplinary perspectives, including psychiatry, pediatrics, family medicine, nursing, philosophy, theology, social work, law, and business. The editors are Marjorie B. Zucker, a retired scientist affiliated with Choice in Dying and Howard Zucker, an Associate Clinical Professor Emeritus of Psychiatry and Medicine at Mount Sinai Medical Center. The book encompasses four main topics. First, it addresses the application of medical futility to diverse healthcare settings and patient populations. Second, it considers a range of cultural, religious, and psychological aspects of medical futility. Third, contributors explore the proper roles for ethics committees, courts, healthcare professionals, the community, and healthcare institutions in defining standards for medical futility. The final section of the book warns readers about potential abuses of medical futility. The purpose is to provide diverse perspectives on the definition and ethical implications of medical futility in a variety of clinical contexts, including acute care, general medicine, pediatric, and nursing home settings. With its combination of theoretical and clinical topics, bioethicists and healthcare professionals will find this book useful. The book is accessible to students of medicine, law, nursing, and ethics and could serve as a supplementary text for bioethics courses. The book underscores the variety of clinical contexts to which medical futility is applied and stresses the importance of distinguishing between medical futility and decisions about health care rationing. It encourages building safeguards into decision-making processes to ensurecareful and accurate futility assessments. This book provides a balanced, cross-disciplinary approach to the controversial topic of medical futility. It shows the importance of taking into account the influence of clinical context, cultural and religious perspectives, psychosocial dimensions, and economic factors.

Nancy S. Jecker