Futility: Case 1
A young accident victim has been in a persistent vegetative state for several months and family members have insisted that "everything possible" be done to keep the patient alive.
What are your professional obligations?
Case 1 illustrates the possible conflicts that can arise with patients or family members about withholding or withdrawing futile interventions. If you and other members of the health care team agree that the interventions in question would be futile, the goals of treatment should be clarified. It can be helpful to ask patients and family members to also articulate their goals, which may reveal some agreement among parties. Once goals are clear, physicians can discuss how various interventions help or frustrate these goals. This requires a process of working with the patient and/or family, and possibly drawing on other resources, such as social workers, palliative care services, hospital chaplains, and ethics consultants. If there is no professional consensus about the futility of a particular intervention, then there is no ethical basis for overriding the requests of patients and/or family members for that intervention.