End of Life (Ethics). Medical Futility at the End of Life

Medical Futility at the End of Life
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Medical Futility at the End of Life
Sustaining life when certain body functions fail is an important aspect of healthcare. Advancement in the medical field has allowed healthcare providers to sustain life for as long as possible. This has been done through life-sustaining treatments such as feeding tubes, dialysis, ventilators, and cardiopulmonary resuscitation (CPR), among others (McCroskey, 2015). While life-sustaining treatments can extend a patient’s life, they often come with complex side effects. Patients at the end of life (EOL) care face difficulties in handling these side effects which include pain and suffering. These are patients who suffer from a terminal illness and their health is deteriorating as time goes by. Life-sustaining treatments, especially at the EOL, have resulted in heavy ethical debate about medical futility at the EOL. Medical futility refers to the use of treatments and interventions that cannot achieve the intended therapeutic goal regardless of the number of times the treatments are used on the patient (McCroskey, 2015). Medical futility also refers to “extending a painful life” using the life-sustaining treatments at the disposal of healthcare providers and patients (Cifrese & Rincon, 2018). Medical futility at the EOL is an ethical concern that needs to be addressed to ensure that the goals of EOL care are met.
Technical Aspects of Medical Futility at the EOL
The term medical futility has been widely researched and discussed in the field of medicine. In recent years, it has become a major challenge to healthcare providers. First, this challenge arises because of the conflict that arises between healthcare providers and patients and/or their families concerning treatment therapies when a patient is at their EOL. Sometimes, healthcare providers and families may have different goals and their goals may also differ from the goals of end of life care. The goal of care for patients who are at the EOL should be to increase their comfort (McCroskey, 2015). The goal should also be to improve their quality of life and let them die with dignity. Yet, families and healthcare providers may have disagreements on whether to continue or discontinue futile treatment (Aghabarary & Nayeri, 2016).
Second, medical futility can result in unethical decision-making among healthcare providers. There is always a concern that treatment that is beneficial to a patient may be discontinued based on a physician's perception of the futility of the treatment (Aghabarary & Nayeri, 2016). When valuable treatment that a physician considered futile is withdrawn, the patient may die prematurely and this raises not only ethical but also legal concerns. Even at EOL, physicians have to ensure that a patient receives valuable life-sustaining treatments up until the point when the treatments are no longer beneficial to the patient.
Third, medical futility has been a challenging issue because it has been associated with high healthcare costs as well as putting a strain on healthcare resources (Aghabarary & Nayeri, 2016). More patients with chronic or terminal illnesses are being admitted in the intensive care unit (ICU) and the demand for resources in the ICU has become higher than the supply. Concerns over the role of medical futility in straining the healthcare system have increased, posing a challenge to healthcare providers.
Description of Public Policy Debates
Due to the problems caused by conflict and disagreement about medical futility, especially in EOL care, there have been public debates on the importance of policy in addressing medical futility at EOL. The first issue in these debates has been whether a policy is needed. As revealed by Aghabarary and Nayeri (2016), a lot of people share the belief that patients should not be provided with futile treatment. The problem, however, arises from the definition of futile treatment. What healthcare providers view and define as futile treatment is not necessarily what patients and their family members view as futile treatment. Therefore, the need for public policy on medical futility has been established in these debates and has been considered a necessity to guide patients, families, and healthcare providers in determining what constitutes futile treatment. The second issue in these debates has been about auth...