Medical Futility and Moral Rights

Abstract

Patients, or their families, sometimes insistently request medical treatments that their physicians believe would be either ineffective or of no benefit. It is not uncommon for someone suffering from an ordinary cold to request that his physician prescribe an antibiotic even though the physician knows that antibiotics are effective only against bacteria, not viruses. A mother might demand that her newborn child be given intensive neonatal care even though he is so premature that he has almost no chance of survival. A patient terminally ill with cancer might beg for a third series of chemotherapy treatments even though the most optimistic prognosis is that this would merely postpone death for a very few weeks of intractable pain. A husband may insist that his wife be continued on intensive care even after she has lapsed into an irreversible coma or persistent vegetative state. Ought physicians, and hospitals, to be legally permitted to refuse to provide futile medical care demanded by patients, or their families? This is an urgent question that arises in current medical practice, has occasioned lively debate in legal periodicals and philosophical journals, and has produced a number of court cases.