Futility in Context

Stuart J. Youngner, MD
JAMA. 1990;264(10):1295-1296. doi:10.1001/jama.1990.03450100085033.
Text Size: A A A
Published online

Two articles in this issue of JAMA1,2 make an important contribution to the growing debate about medical futility. The authors present a strong case that futile resuscitation need not be offered to patients and their families and may be denied when they request it. I have argued elsewhere that physicians might unreasonably diminish patient autonomy by acting on poorly defined notions of futility.3 These articles make an equally important observation: by offering life-sustaining treatment that they consider futile, physicians may actually undermine patient and family autonomy. Such offers send a mixed message, implying a real choice when none exists. Furthermore, physicians have a socially sanctioned responsibility to evaluate, promote, and, when necessary, protect patients' best interests. As Tomlinson and Brody note, this role inevitably involves making value judgements as the physician weighs the potential harms and benefits of any given intervention. If such value judgments are "socially validated,"


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.