Abstract

The concept of futility remains a hotly debated topic in modern bioethics. Some commentators argue that the concept itself is clinically meaningless and a nuisance to patient autonomy. Others have even struck out to replace the term "futility" with new, ambiguous language. That temptation is resisted here. This dissertation's first part builds upon highly developed senses of "futility" in medical care from the work of Lawrence J. Schneiderman and Nancy S. Jecker, enriching the concept by the addition of a third axis, thus allowing futility judgments to be made in much the same way as multi-dimensional disorders such as Alcoholism are diagnosed. The second part sets the multi-axial futility concept into three settings of medical practice culminating in a moral defense for withholding or withdrawing futile medical care even over the insistence of patients and their surrogates on demanding it