Verified Document

Medical Futility And The Vulnerables: Research Proposal

The social and legal issues are highlighted in cases that involve pre-term infants. In the elderly, the cultural consensus is that these persons have lived their life and are close to death anyway. However, in the case of a pre-term infant, the issue is raised of what measures should be taken to preserve life, particular when there is a lack of resources (Seri and Evans 2008). In the case of premature infants, significant cases exist to aid in the establishment of criteria to predict survival rates. If the survival probability is too low, resources are typically saved for those infants that have a greater chance for survival. For instance, it is the general rule that babies under 23-week and that weigh less than 500 grams are unlikely to survive. However, babies over 25 weeks and that weigh at least 600 grams have a high likelihood of survival and therefore warrant interventions to save their lives (Seri and Evans 2008). The real question lies in infants that are in the grey zone between these two extremes. This is similar to the healthy, elderly woman discussed earlier.

This exploration of the topic of medical futility and the decision to withhold care focused on the perspective of the health care facility and the individual doctor who must make the decision. The decision to withhold care has a significant impact on the doctor's future and ability to practice medicine. The doctor himself is under the greatest legal and moral liability in these cases, as they are the ones to make the important decisions. This research examined the question of medical futility using an example of a case that falls into the grey zone of decision making in these regards.

The literature found several sets of criteria that have been developed with the intention of aiding doctors in their decision to withhold life saving treatment. In the past, this decision has been largely decided by the personal opinions and beliefs of the doctors. In the UK, the courts can intervene in cases of coma. However, many times, the decisions must be made in a split second, particularly in the emergency room setting. Cultural and religious differences between the doctor, patient, staff, and the patient's family may cloud the decision. In practice, it is the decision of the doctor that holds the most weight from a legal standpoint.

The need to develop a set of viable standards and guidelines for helping doctors make life saving or ending decisions is clear. However, current attempts to develop these criteria has only resulted in more controversy over bias on the part of the doctor. No studies could be identified that examined the opinions and criteria used by doctors in the UK to help determine who is treated and who does not. A study similar to this was found concerning Japanese doctors, but none was found that was culturally relevant to doctors in the UK. There is a clear need for the development of criteria for making life-ending decisions among UK doctors.

The first step in arriving at a consistent consensus is to determine what criteria a majority of the doctors in he UK use to determine...

This study will survey emergency room doctors, as they must often be the sole person responsible for making those decisions. They often do not have the luxury of a court making the decision, as emergency room decisions do not have the luxury of a sufficient period to obtain a court decision. This study will examine the criteria used by doctors in determining who is treated and who does not when resources are limited.
This study is a necessary step in arriving at clinically valid consensus regarding the criteria that doctors currently use to determine who gets bed space when bed space is limited. It will pay particular attention to the factor of age and when doctors feel that lifesaving measures are futile in terms of a patient's age. This study will provide valuable insight into the decisions that are currently being made regarding age-related emergency room decisions and use of resources. It is the first step in the development of standards of care concerning withholding of treatment for the elderly.

References

Bagheri, a., Asai, a., and Ida, R. 2006. Expert's attitudes towards medical futility: an empirical survey form Japan. BMC Medical Ethics. June 2006, pp. 7-8. Accessed February 28, 2009 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1550716

Del Poze, R. And Fins, J. 2005. Death, dying and informatics: misrepresenting religion of Medline. BMC Medical Ethics. 6 (6). Accessed February 28, 2009 http://www.biomedcentral.com/1472-6939/6/6

Faunce, T. And Stewart, C. 2005. The Messiha and Schiavo cases: third-party ethical and legal interventions in futile care disputes. MJA. 183 (5). 261-263. Accessed February 28, 2009 http://www.mja.com.au/public/issues/183_05_050905/fau10214_fm.pdf

Gampel, E. 2006. Does Professional Autonomy Protect Medical Futility Judgments? Bioethics. 20 (2), 92-104.

Mason, T. 2008. Ellen Westwood: Unilaterally Refusing LSMT in UK. Medical Futility. July 10, 2008. Accessed February 28, 2009 http://medicalfutility.blogspot.com/2008/07/ellen-westwood-unilaterally-refusing.html

Mohindra, R. 2007. Medical Futility: a conceptual model. Journal of Medical Ethics. 33: 71-75.

Samanta, a. And Samanta, J. 2008. Do not attempt resuscitation orders: the role of clinical governance. Clinical Governance: An International Journal. 13 (3), 215-220.

Seri, I and Evans, J. 2008. Limits of viability: definition of the gray zone. Journal of Perinatology. 28, S4-S8. Accessed February 28, 2009 http://www.nature.com/jp/journal/v28/n1s/abs/jp200842a.html

Smith, W. 2004. Suing for the Right to Live. The Weekly Standard. March 11, 2004. Accessed February 28, 2009 http://www.weeklystandard.com/Content/Public/Articles/000/000/003/836zeecs.asp

Terra, S. 2006. Approach to Medical Futility in a Community Hospital: Is Use of a Prognostic Scoring System Applicable? The Internet Journal of Allied Health Sciences and Practice. 4(4): 1-11. Accessed February 28, 2009 http://ijahsp.nova.edu/articles/vol4num4/terra.pdf

Sources used in this document:
References

Bagheri, a., Asai, a., and Ida, R. 2006. Expert's attitudes towards medical futility: an empirical survey form Japan. BMC Medical Ethics. June 2006, pp. 7-8. Accessed February 28, 2009 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1550716

Del Poze, R. And Fins, J. 2005. Death, dying and informatics: misrepresenting religion of Medline. BMC Medical Ethics. 6 (6). Accessed February 28, 2009 http://www.biomedcentral.com/1472-6939/6/6

Faunce, T. And Stewart, C. 2005. The Messiha and Schiavo cases: third-party ethical and legal interventions in futile care disputes. MJA. 183 (5). 261-263. Accessed February 28, 2009 http://www.mja.com.au/public/issues/183_05_050905/fau10214_fm.pdf

Gampel, E. 2006. Does Professional Autonomy Protect Medical Futility Judgments? Bioethics. 20 (2), 92-104.
Mason, T. 2008. Ellen Westwood: Unilaterally Refusing LSMT in UK. Medical Futility. July 10, 2008. Accessed February 28, 2009 http://medicalfutility.blogspot.com/2008/07/ellen-westwood-unilaterally-refusing.html
Seri, I and Evans, J. 2008. Limits of viability: definition of the gray zone. Journal of Perinatology. 28, S4-S8. Accessed February 28, 2009 http://www.nature.com/jp/journal/v28/n1s/abs/jp200842a.html
Smith, W. 2004. Suing for the Right to Live. The Weekly Standard. March 11, 2004. Accessed February 28, 2009 http://www.weeklystandard.com/Content/Public/Articles/000/000/003/836zeecs.asp
Terra, S. 2006. Approach to Medical Futility in a Community Hospital: Is Use of a Prognostic Scoring System Applicable? The Internet Journal of Allied Health Sciences and Practice. 4(4): 1-11. Accessed February 28, 2009 http://ijahsp.nova.edu/articles/vol4num4/terra.pdf
Cite this Document:
Copy Bibliography Citation

Related Documents

Medical Futility in Nursing Care Caring and
Words: 3647 Length: 12 Document Type: Essay

Medical Futility in Nursing Care CARING AND CHOOSING Bioethics is described as both a field of intellectual inquiry and a professional practice that examines moral questions affecting various disciplines (Arras, 2007). These disciplines include biology, medicine, law, public health, policy and ethics. In these disciplines are scholars, teachers, and clinical practitioners, including nurses. Their work has recently been subjected to an unprecedented turn in perspectives concerning relevant issues and behaviors. Among these

Moral Dilemma
Words: 578 Length: 2 Document Type: Essay

Moral and Medical Dilemma As the progression of medical technology has expanded humanity's ability to heal one another directly -- through the process of organ transplants, blood transfusions, and bone marrow exchanges -- several ethical dilemmas have surfaced which impact physicians, patients, and politicians alike. An individual's voluntary decision to donate his or her organs in the event of an unexpected death, and the government's methods for devising an equitable system

Legalizing Prostitution in California This
Words: 8336 Length: 32 Document Type: Thesis

As far back as 1959, the United Nations recognized the logic and benefits of decriminalizing prostitution, and organizations supporting this decriminalization include the "American Civil Liberties Union, the National Organization of Women, and various prostitute 'unions', the most famous of which is COYOTE (Call Off Your Old Tired Ethics)" (Rio, 1991, p. 206). And as far back as 1971, the San Francisco Committee on Crime considered the legalization of

Military Employee Stress the Objective
Words: 18029 Length: 66 Document Type: Thesis

The subjects were 613 injured Army personnel Military Deployment Services TF Report 13 admitted to Walter Reed Army Medical Center from March 2003 to September 2004 who were capable of completing the screening battery. Soldiers were assessed at approximately one month after injury and were reassessed at four and seven months either by telephone interview or upon return to the hospital for outpatient treatment. Two hundred and forty-three soldiers

Piaf, Pam Gems Provides a View into
Words: 46193 Length: 125 Document Type: Dissertation

In "Piaf," Pam Gems provides a view into the life of the great French singer and arguably the greatest singer of her generation -- Edith Piaf. (Fildier and Primack, 1981), the slices that the playwright provides, more than adequately trace her life. Edith was born a waif on the streets of Paris (literally under a lamp-post). Abandoned by her parents -- a drunken street singer for a mother and a

Cnos: Proposed Study
Words: 6509 Length: 21 Document Type: Dissertation or Thesis complete

civilians think of the nursing department in any well-run hospital, they often don't consider all the structure, organization and guidance which is required to make this department run as smoothly as it needs to be and to achieve the highest level of patient-centered goals. One position at the top of the pyramid of the nursing department is the position of Chief Nursing Officer or CNO. The Chief Nursing Officer

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now