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Physician Refusal of Requests for Futile or Ineffective Interventions

Published online by Cambridge University Press:  10 December 2009

John J. Paris  and
Frank E. Reardon
John J. Paris
Affiliation:
University of Massachusetts Medical School
Frank E. Reardon
Affiliation:
Brigham & Women's Hospital, Boston.
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Extract

Several recent articles raise an issue long unaddressed in the medical literature: physician compliance with patient or family requests for futile or ineffectice therapy. Although they agree philosophically that such treatment ought not be given, most physicians have followed the course described by Stanley Fiel, in which a young patient dying of cystic fibrosis was accepted “for evaluation” by a transplant center even though he has already passed the threshold of viability as a candidate for a heart-lung transplant. Dr. Fiel reported this action was taken not in the hope of doing the transplant but so that the family could assure themselves they had done “everything possible.” The patient, after a long and stressful cross-country flight, arrived at the hospital in respiratory failure. He died soon thereafter far from home and familiar surroundings.

Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 1 , Issue 2 , Spring 1992 , pp. 127 - 134
Copyright
Copyright © Cambridge University Press 1992

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References

Notes

1. Paris, JJCrone, RKReardon, F.Physicians' refusal of requested treatment: the case of Baby L. New England Journal of Medicine 1990; 322: 1012–5.CrossRefGoogle ScholarPubMed

2. Tomlinson, TBrody, H.Futility and the ethics of resuscitation. Journal of the American Medical As sociation 1990; 264: 1276–80.CrossRefGoogle Scholar

3. Hackler, JCHiller, FC.Family Consent to orders not to resuscitate: reconsidering hospital policy. Journal of the American Medical Association 1990; 264: 1281–3.CrossRefGoogle Scholar

4. Fiel, SB.Heart–lung transplantation for patients with cystic fibrosis. Archives of Internal Medicine 1991; 151: 870–2.CrossRefGoogle ScholarPubMed

5. Tresch, DDSims, FHDuthie, EH et al. Clinical characteristics of patients in the persistent vegetative state. Archives of Internal Medicine 1991; 151: 930–2.CrossRefGoogle ScholarPubMed

6. Fiel, S.Heart-lung transplantation for patients with cystic fibrosis. Archives of Internal Medicine 1991; 151: 870–2.CrossRefGoogle ScholarPubMed

7. Tomlinson, TBrody, H.Futility and the ethics of resuscitation. Journal of the American Medical Association 1990; 264: 1276–80.CrossRefGoogle Scholar

8. Wolf, SM. “Near death” —in the moment of decision. New England Journal of Medicine 1990; 322: 208–10. See p. 209.CrossRefGoogle Scholar

9. Pellegrino, E.Ethics in AIDS treatment decisions. Origins 1990: 19: 539–44.Google Scholar

10. Brock, DWWartman, SA.When competent patients make irrational choices. New England Journal of Medicine 1990; 322: 1595–9.CrossRefGoogle ScholarPubMed

11. New York State Task Force on Life and the Law. Do Not Resuscitate Orders: The Proposed Legislation and Report of the New York State Task Firce on Life and the Law. Albany, New York: The Task Force, 1986.Google Scholar

12. Rosenthal, E.Rules on reviving the dying bring undeue suffering, doctors contend. New York Times 1990 Oct. 4:A1.Google ScholarPubMed

13. Amundsen, DW.The physician's obligation to prolong life: a medical duty without classical roots Hastings Center Reports 1978; 8: 23–30.CrossRefGoogle ScholarPubMed

14. Deciding To Forego Life-Sustaining Treatment: A Report on the Ethical, Medical and Legal Issues in Treatment Decisions. Washington, D.C.: President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 1983. See p. 3.Google Scholar

15. Paris, JJCrone, RKReardon, F.Physicians' refusal of requested treatment: the case of Baby L. New England Journal of Medicine 1990; 322: 1012–5.CrossRefGoogle ScholarPubMed

16. Fiel, S.Heart–lung transplantation for patients with cystic fibrosis. Archives of Internal Medicine 1991; 151: 870–2.CrossRefGoogle ScholarPubMed

17. Tresch, DDSims, FHDuthie, EH et al. Clinical characteristics of patients in the persistent vegetative state. Archives of Internal Medicine 1991; 151: 930–2.CrossRefGoogle ScholarPubMed

18. Hadorn, DC.Setting health care priorities in Oregon. Cost-effectiveness meets the rule of rescue. Journal of the American Medical Association 1991; 265: 2218–25.CrossRefGoogle ScholarPubMed

19. Chervenak, FAMcCullough, LB.Justified limits on refusing intervention. Hastings Center Report 1991; 21: 12–8.CrossRefGoogle ScholarPubMed

20. Younger, SJ.Who degines futility? Journal of the American Medical Association 1990; 260: 2094–5.CrossRefGoogle Scholar

21. Tomlinson, TBrody, H.Futility and the ethics of resuscitation. Journal of the American Medical Association 1990; 264: 1276–80.CrossRefGoogle Scholar

22. Hackler, JCHiller, FC.Family consent to order not to resuscitate. Journal of the American Medical Association 1990; 264: 1281–3.CrossRefGoogle ScholarPubMed

23. Bedell SF Delbanco TL Cook EF Survival after cardiopulmonart resuscitation in the hospital. New England Journal of Medicine 1983; 309: 569–76.Google Scholar

24. Blackhall, LJ.Must we always use CPR? New England Journal of Medicine 1987; 317: 1281–4. See p. 1281.CrossRefGoogle ScholarPubMed

25. Tomlinson, T.Brody H. Ethics and communication in do-not-resuscitate orders. New England Journal of Medicine 1988; 318: 43–6. See p. 43.CrossRefGoogle ScholarPubMed

26. Murphy, DJ.Do-not-resuscitate orders: time for reappraisal in long-term care institutions. Journal of the American Medical Association 1989; 260: 2098–2101.CrossRefGoogle Scholar

27. Lantos JD. Miles SM Silverstein MD Survival after cardiopulmonary resuscitation in babies of very low birth weight: Is CPR futile therapy? New England of Medicine 1988; 318: 91–5.Google Scholar

28. Younger, SJ.Who defines futility? Journal of the American Medical Association 1990; 260: 2094–5.CrossRefGoogle Scholar

29. Murphy, DJ.DO-not-resuscitate orders: time for reappraisal in long-term care institutions. Journal of the American Medical Association 1989; 260: 2098–2101.CrossRefGoogle Scholar

30. Lantos, JDSinger, PAWalker, RM et al. The illusion of futility in clinical practice. The American Journal of Medicine 1989; 87: 87: 83.CrossRefGoogle ScholarPubMed

31. SEe note 30. Lantos et al. 1989; 87: 83.Google Scholar

32. Schneiderman, LJJecker, NSJonsen, ARMedical futility: its meaning and ethical implications. Annals of Internal Medicine 1990; 112: 949–54.CrossRefGoogle ScholarPubMed

33. See note 32. Schneiderman et al. 1990; 112: 950.Google Scholar

34. Moore, FD.The desperate case: CARE (costs, applicability, reserach, ethics). Journal of the American Medical Association 1991; 261: 1483–4. See p. 1483.CrossRefGoogle Scholar

35. Selection from the Hippocratic Corpus: “The Art” (circa 5th-4th century B.C.). In: Reiser SJ, Dyck AJ, Curran WJ, eds. Ethics in Medicine: Historical Perspective and Contemporary Concerns Cambridge, Massachusetts: MIT Press, 1977: 6–7.Google Scholar

36. Plato. The Republic. Translated by GMA Grude. Indianapolis: Hackett Publishing Co., 1974.Google Scholar

37. Vatican. Declaration on euthanasia, the Sacred Congregation for the Doctrines of the Faith. In: Deciding to Forego Life-Sustaining Treatment: A Report on the Ethical, Medical, and Legal Issues in Treatment Decisions. Washington, D.C.: President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 1983; 322: 1012–5.Google Scholar

38. Paris, JJCrone, RKReardon, F.Physicians' refusal of requested treatment: the case of Baby L. New England Journal of Medicine 1990; 322:1012–5.Google ScholarPubMed

39. Brophy v. New England Sinai Hospital 398 Mass, 417, 497 N.E. 2d 626 (1986).Google Scholar

40. Hackler, JCHiller, FC.Family consent to orders not to resuscitate: reconsidering hospital policy. Journal of the American Medical Association 1990; 264: 1281–3.CrossRefGoogle Scholar

41. Tomlinson, TBrody, H.Futility and the ethics of resuscitation. Journal of the American Medical As sociation 1990; 264: 1276–80.CrossRefGoogle Scholar

42. Younger, SJ.Futility in context Journal of the American Medical Association 1990; 264: 1295–6.CrossRefGoogle Scholar

43. Hackler, JCHiller, FC.Family Consent to orders not to resuscitate: reconsidering hospital policy. Journal of the American Medical Association 1990; 264: 1281–3.CrossRefGoogle Scholar

44. See note 3. Hackler and Hiller. 1990; 264: 1282.Google Scholar

45. See note 3. Hackler and Hiller. 1990; 264: 1282.Google Scholar