Nurses' Perceptions of Futile Medical Care

Abstract

The increasing progress in medical and health sciences has enhanced patient survival over the years. However, increased longevity without quality of life in terminally ill patients has been a challenging issue for care providers, especially nurses, since they are required to determine the futility or effectiveness of treatments. Futile care refers to the provision of medical care with futile therapeutic outcomes for the patient. Interest in this phenomenon has grown rapidly over the years. In this study, we aimed to review and identify nurses’ perceptions of futile care, based on available scientific resources. In total, 135 articles were retrieved through searching scientific databases (with no time restrictions), using relevant English and Farsi keywords. Finally, 16 articles, which were aligned with the study objectives, were selected and evaluated in this study. Overlapping studies were excluded or integrated, based on the research team’s opinion. According to the literature, futile care cannot be easily defined in medical sciences, and ethical dilemmas surrounding this phenomenon are very complex. Considering the key role of nurses in patient care and end-of-life decision-making and their great influence on the attitudes of patients and their families, support and counseling services on medical futility and the surrounding ethical issues are necessary for these members of healthcare teams.

Perceptions of intensive care unit nurses of therapeutic futility: A scoping review

“…24 This participation can have a significant impact on the person's and family's experience, significantly influencing the attitudes of people and family members. 9 A direct relationship has been observed between therapeutic futility and resource waste, moral conflicts, and nurses' exhaustion, 9 and a negative relationship between the perception of futile care and the behavior of nurses in care has been highlighted. 11 The authors of this review identify as limitations studies with unrepresentative samples, studies with participants with limited professional experience in caring for critically ill patients, and studies conducted in highly complex units.…”

“…This may be related to the increase in life expectancy, technological advances, the latest medical equipment, the rising costs associated with health care, and a growing concern for people's autonomy. 9 Today, although it is generally agreed that therapeutic futility is a difficult concept to define whose meaning may vary in different countries, depending on existing culture, values, religion, beliefs, and medical advances, 10 some authors find "futile" to refer to care or treatment that has no benefit to the person, 11 consisting of the provision of inadequate treatments that may not contribute to improving prognosis, relieving symptoms, or prolonging life. 12 However, advancing a definition of therapeutic futility and knowing how to recognize it is a complex and sensitive process that raises questions for which concrete answers are difficult to find, 13 since futility is related to assumptions about quality and span of life and may be invoked in an ethically unjustifiable way.…”

The Troubled Nurse: A Qualitative Study of Psychoemotional Effects of Cancer Care on Nurses in A Nigerian Cancer Care Setting

“…Futile care refers to the provision of medical care with fruitless therapeutic outcomes for the patient. [ 20 ] Futile care may also involve any type of care which neither enhances patients' survival or hospital discharge nor helps them maintain or promote their quality of life[ 22 23 ] which clearly portrays the sentiment of a nurse who expressed that “working here so far has not been fulfilling to me as a nurse. The reason for this is that majority, if not all of our patients end up dying.” Another nurse also narrated that “it is not easy to nurse patients that you know will not survive.” For these nurses, the care provided to the cancer patients didn't have any long lasting impact making the nurses feel incapacitated.…”

Unconscious patient - role and tasks of the therapeutic team

“…9 The work of every member of the therapeutic team, especially in the case of unconscious patients in intensive care units, is extremely important in the course of effective treatment and rehabilitation of the patient. 10 The conducted studies show that the majority (over 76%) of the members of therapeutic teams are women, most often aged 36-45 years (over 50% of the respondents). The vast majority of members of therapeutic teams have higher education (almost 75%).…”