Abstract

The term “medical futility” was developed in the 1980s to enable physicians to withdraw life-prolonging procedures over the objections of patients or family members. Using clinical expertise, the physician determines that a particular treatment would be futile in a particular clinical situation. A futility judgment is clear cut when the procedure does not work, but a difficulty arises when a physician believes that a procedure provides too little benefit and then invokes futility. In that case, a patient might consider if the relatively small medical benefit might contribute to appropriately defined goals of treatment, and if so request “extraordinary means.” This article places the concept “medical futility” in relation to the principle of ordinary and extraordinary means, clarifies the concept of futility, and explains the problem of redefining futile means to include procedures that retain some benefit. It advocates very limited use of the term “medical futility” and suggests an alternative reason to withhold or withdraw treatment. National Catholic Bioethics Quarterly 14.1 : 39–45.