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Keywords

decision making, ethics, medical, medical futility, prognosis, resuscitation orders, treatment outcome

 

Authors

  1. Cogliano, Janet F. DNSc, RN, CS

Abstract

Medical futility is a recent, complex bioethical issue. There is disagreement about how futility should be defined and who should be involved in futility decisions when an impasse exists between the patient/family and the physician. Bioethical discussions about Quinlan and Cruzan of the past have been replaced with the Wanglie, Baby K, and Linares cases-all of which involved critical care settings. Nurses often are involved in the debate and encounter ethical conflicts. Cost-containment, managed care, scarce resource allocation, and care due the elderly have fueled the debate. Key issues and their importance for critical care nurses will be reviewed.