Medical Futility in End-of-Life Care

JAMA ◽  
1999 ◽  
Vol 282 (14) ◽  
pp. 1331-1332 ◽  
Author(s):  
A. Halevy
2018 ◽  
Vol 32 (1) ◽  
pp. 12-22 ◽  
Author(s):  
Pei-Fan Mu ◽  
Yun-Min Tseng ◽  
Chia-Chi Wang ◽  
Yi-Ju Chen ◽  
Shu-He Huang ◽  
...  

The experiences of end-of-life care by nurses in the pediatric intensive care unit are the subject of this systematic review. Six qualitative articles from three different countries were chosen for the review using methods from Joanna Briggs Institute. The themes discovered included the following: insufficient communication, emotional burden, moral distress from medical futility, strengthening resilience, and taking steps toward hospice. These themes are discussed in detail followed by recommendations for practice to assist nurses in their quest for a good death for their pediatric patients.


2016 ◽  
Author(s):  
Christie Bowser

<p>Nurses are responsible for providing care for patients and following through with a physician’s orders, however, it is not always easy to do. Certain cases are more difficult than others, especially those involving end-of-life care versus continuing with life-sustaining measures. It is not an easy decision for families or patients to make, but sometimes these life-sustaining interventions can do more harm than good, causing much distress among caregivers (Burns & Truog, 2007). Some cases have become hallmark cases like that of Terri Schiavo, a woman who was in a persistent vegetative state from 1990 to 2005 while her parents and husband fought between keeping her alive or letting her go peacefully (Quill, 2005). Another difficult case in 2007 involved a toddler, Emilio Gonzales, whose mother fought for more time with her child rather than removing the ventilator (Cohen, 2007).</p> <p>Defining futility and its role in healthcare has been an ongoing issue since the 1980s. For the purpose of this research paper, futility is defined as “treatment or clinical interventions that are not likely to result in benefit to the patient or produce the expected outcome” (Terra & Powell, 2012, p. 103). Nurses can suffer from moral distress when they are obligated to provide life-sustaining interventions to patients that have a small chance of benefiting from them. Nurses may experience less frustration and moral distress if hospitals implement a futility policy that provides guidance in these difficult cases. The purpose of this study is to explore nurses' attitudes regarding a hospital-based medical futility policy. </p>


2011 ◽  
Vol 31 (5) ◽  
pp. 64-69 ◽  
Author(s):  
Claire M. McGowan

Critical care nurses are essential members of the health care team and often assist patients and patients’ families who are facing end-of-life concerns. In that role, a nurse needs an understanding of many important factors, including legal implications associated with the end of life. Since the 1970s, courts have decided several cases that have established legal principles in end-of-life care. Courts have found that competent adults have the right to refuse or discontinue medical interventions. For incompetent adults and children, decisions are made by a surrogate. In the absence of an advance directive or documentation of goals of care, the surrogate, in collaboration with the medical team, determines a plan of care, including decisions about end-of-life care. When issues of medical futility occur, attempts to work with patients and their families should be undertaken, but if the dispute cannot be resolved, a transfer in care may be the only option.


JAMA ◽  
1999 ◽  
Vol 281 (10) ◽  
pp. 937-941 ◽  
Author(s):  
Council on Ethical and Judician Affairs, American Medical Association

2014 ◽  
Vol 23 (4) ◽  
pp. 173-186 ◽  
Author(s):  
Deborah Hinson ◽  
Aaron J. Goldsmith ◽  
Joseph Murray

This article addresses the unique roles of social work and speech-language pathologists (SLPs) in end-of-life and hospice care settings. The four levels of hospice care are explained. Suggested social work and SLP interventions for end-of-life nutrition and approaches to patient communication are offered. Case studies are used to illustrate the specialized roles that social work and SLP have in end-of-life care settings.


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