Point: The Texas Advance Directives Act Effectively and Ethically Resolves Disputes About Medical Futility

Fine, Robert L.

doi:10.1378/chest.09-1267

Cited by 40 publications

(32 citation statements)

References 17 publications

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“…Surrogates opposed to the withdrawal of life support appealed to the ethical principle of autonomy and the concept of vitalism to support the continued use of life-sustaining measures. 2 In addition, opponents of the belief that physicians had a right to determine futility felt that this label used by physicians was reverting back to a form of medical paternalism in which physicians may be "given the power to impose on their patients their own personal values under the guise of medical expertise." 5(p369) In response to objections such as this, many attempts were made to reach a concrete definition of what medical futility is.…”

Section: The Concept Of Medical Futilitymentioning

confidence: 99%

“…However, it can be a time-consuming and resource-taxing endeavor if the surrogate does not come to an agreement before the court proceedings begin. 2 With an established procedure in place, these issues can be alleviated.…”

Section: Ethical and Legal Issuesmentioning

confidence: 99%

“…27 If an alternative facility willing to provide life-sustaining treatment cannot be found, unilateral removal of the life-sustaining treatment by the facility, without risk of criminal or civil liability, is permitted. 2 In many health care facilities outside of Texas, when confl ict arises regarding futility, often the institutional ethics committee or physicians will advise the surrogate to search for another facility willing to continue the desired life-sustaining treatment. However, if an alternative facility cannot be found, often the facility has little choice but to continue providing life-sustaining treatment indefi nitely.…”

Section: The Texas Advance Directives Act Of 1999mentioning

confidence: 99%

“…First, the law can help clinicians preserve moral integrity. 2,26,27,30 To maintain a patient on a treatment that a clinician finds inappropriate, ineffective, or futileand possibly harmful-requires the clinician to act against his or her medical and ethical judgment. On the one hand, the importance of respecting patients' autonomy, even if operational through the request of a surrogate, needs to be recognized.…”

Section: Strengths and Advantages Of Tadamentioning

confidence: 99%

“…2,26,27 In recognizing legitimate moral concerns on both sides, the law, in the words of Thomas Mayo, "tries to steer a course between the Scylla of judicial review and the Charybdis of unfettered, unexamined physician discretion." 27(p1010) Third, along with the question of clinician integrity, the law's defenders also claim that it could help reduce the problem of moral distress.…”

Section: Strengths and Advantages Of Tadamentioning

confidence: 99%

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The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

Olmstead

Dahnke

2016

Critical Care Nurse

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The issue of medical futility requires a well-defi ned process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is fi rst determined by medicine, in order for the determination to meet legal criteria, it must be subject to review. The hope is that through a review process that meets legal criteria, the issue can be resolved without the need for court proceedings. If resolution cannot be obtained through this process, surrogates still have the right to seek court intervention. This issue is of relevance and importance in critical care nursing because of the role and position of critical care nurses, who have direct contact with patients and patients' families, the potential for moral distress in cases of possibly futile treatment, and the expanding roles of nurses, including critical care nurses and advanced practice nurses, in management and policy development. (Critical Care Nurse. 2016;36[6]:13-23) M rs J, an 88-year-old woman with an admitting diagnosis of change in mental status, originally on a nonmonitored medical surgical unit, was a full code. During her stay in the hospital, she had pneumonia develop. Mrs J underwent cardiopulmonary resuscitation (CPR) several times and was transferred to the intensive care unit, back to the medical surgical unit, then to an intermediate care unit, and back to the intensive care unit. During the last CPR attempt, Mrs J was intubated and became ventilator dependent. During her admission, Mrs J had been deemed not competent to make her own decisions by

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Section: The Concept Of Medical Futilitymentioning

confidence: 99%

Section: Ethical and Legal Issuesmentioning

confidence: 99%

Section: The Texas Advance Directives Act Of 1999mentioning

confidence: 99%

Section: Strengths and Advantages Of Tadamentioning

confidence: 99%

Section: Strengths and Advantages Of Tadamentioning

confidence: 99%

See 3 more Smart Citations

The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

Olmstead

Dahnke

2016

Critical Care Nurse

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The Use of Informed Assent in Withholding Cardiopulmonary Resuscitation in the ICU

Curtis

2012

AMA Journal of Ethics

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ETHICS CASEThe Use of Informed Assent in Withholding Cardiopulmonary Resuscitation in the ICU Commentary by J. Randall Curtis, MD, MPH Ms. Rose's family had gathered in the intensive care unit conference room. Her three sons and daughter all looked haggard; their mother's advancing lung cancer had led to a long stay in the intensive care unit (ICU). This was the second conference since their mother was intubated a week before. After that meeting, she'd done well with treatments, and the breathing tube had just been removed, although she was still drifting in and out of consciousness. However, the last few days had been increasingly difficult, and, although Ms. Rose's lung function was improved, she was no longer aware of what was going on around her. Her heart had weakened, and her blood pressure had slowly been dropping despite medications.

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The Ethics of Transplantation

Gibney,

Entwistle

2023

Textbook of Transplantation and Mechanical Support for End‐Stage Heart and Lung Disease

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Point: The Texas Advance Directives Act Effectively and Ethically Resolves Disputes About Medical Futility

Cited by 40 publications

References 17 publications

The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

The Use of Informed Assent in Withholding Cardiopulmonary Resuscitation in the ICU

The Ethics of Transplantation

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