Medical futility decisions and physicians' legal defensiveness: The impact of anticipated conflict on thresholds for end-of-life treatment

Dying, death and bereavement: a qualitative study of the views of carers of people with heart failure in the UK

“…A one per cent chance of survival has been suggested as a cut off point [ 30 ]. Swanson and McCrary [ 31 ] found that different risk calculations were adopted for people who have a progressive and incurable disease, futility was assumed even if the percentage chance of survival was greater than one per cent. But as we have seen, even with a less restrictive definition of futility, there are still differences between medical staff and family carers.…”

Dying, death and bereavement: a qualitative study of the views of carers of people with heart failure in the UK

“…A one per cent chance of survival has been suggested as a cut off point [ 30 ]. Swanson and McCrary [ 31 ] found that different risk calculations were adopted for people who have a progressive and incurable disease, futility was assumed even if the percentage chance of survival was greater than one per cent. But as we have seen, even with a less restrictive definition of futility, there are still differences between medical staff and family carers.…”

Neonatology and the specter of the law

“…We next asked ourselves how extreme legal defensiveness might affect physicians' perceptions of futility and how that might, in turn, affect interactions with patients and their families. Analyzing the same data, we found that a majority of physicians indicated that the probability of success defining futile treatment should generally be lower for patients with potential to benefit more from life-sustaining interventions (e.g., patients who are sentient), and higher for patients with less potential to benefit (e.g., patients in a permanent vegetative state) [30]. Stated another way, most physicians perceive longer odds worth pursuing for greater potential gain -a position that seems logically consistent with most patients' rational self interest.…”

What does “futility” mean? An empirical study of doctors' perceptions

“…The debate has been linked with the perceived conflict between patient and physician autonomy, with early efforts to reach consensus on a definition of futility seen as an attempt to resolve this conflict 6 . However, futile treatment is not always the result of patient or family requests, with studies identifying a range of contributing factors 7 , 8 …”

Dying, death and bereavement: a qualitative study of the views of carers of people with heart failure in the UK

“…A one per cent chance of survival has been suggested as a cut off point [ 30 ]. Swanson and McCrary [ 31 ] found that different risk calculations were adopted for people who have a progressive and incurable disease, futility was assumed even if the percentage chance of survival was greater than one per cent. But as we have seen, even with a less restrictive definition of futility, there are still differences between medical staff and family carers.…”

Neonatology and the specter of the law

“…We next asked ourselves how extreme legal defensiveness might affect physicians' perceptions of futility and how that might, in turn, affect interactions with patients and their families. Analyzing the same data, we found that a majority of physicians indicated that the probability of success defining futile treatment should generally be lower for patients with potential to benefit more from life-sustaining interventions (e.g., patients who are sentient), and higher for patients with less potential to benefit (e.g., patients in a permanent vegetative state) [30]. Stated another way, most physicians perceive longer odds worth pursuing for greater potential gain -a position that seems logically consistent with most patients' rational self interest.…”

What does “futility” mean? An empirical study of doctors' perceptions

“…The debate has been linked with the perceived conflict between patient and physician autonomy, with early efforts to reach consensus on a definition of futility seen as an attempt to resolve this conflict 6 . However, futile treatment is not always the result of patient or family requests, with studies identifying a range of contributing factors 7 , 8 …”

Dying, death and bereavement: a qualitative study of the views of carers of people with heart failure in the UK

“…A one per cent chance of survival has been suggested as a cut off point [ 30 ]. Swanson and McCrary [ 31 ] found that different risk calculations were adopted for people who have a progressive and incurable disease, futility was assumed even if the percentage chance of survival was greater than one per cent. But as we have seen, even with a less restrictive definition of futility, there are still differences between medical staff and family carers.…”

Neonatology and the specter of the law

“…We next asked ourselves how extreme legal defensiveness might affect physicians' perceptions of futility and how that might, in turn, affect interactions with patients and their families. Analyzing the same data, we found that a majority of physicians indicated that the probability of success defining futile treatment should generally be lower for patients with potential to benefit more from life-sustaining interventions (e.g., patients who are sentient), and higher for patients with less potential to benefit (e.g., patients in a permanent vegetative state) [30]. Stated another way, most physicians perceive longer odds worth pursuing for greater potential gain -a position that seems logically consistent with most patients' rational self interest.…”

What does “futility” mean? An empirical study of doctors' perceptions

“…The debate has been linked with the perceived conflict between patient and physician autonomy, with early efforts to reach consensus on a definition of futility seen as an attempt to resolve this conflict 6 . However, futile treatment is not always the result of patient or family requests, with studies identifying a range of contributing factors 7 , 8 …”