The Texas Advance Directives Act of 1999: An Exercise in Futility?

Zientek, Mark

doi:10.1007/s10730-005-5151-1

Cited by 6 publications

(7 citation statements)

References 11 publications

(5 reference statements)

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“…It provides a process for resolving conflicts between patients or surrogate decision-makers and health care providers regarding the perceived futility of particular therapeutic interventions via an institutional committee [15]. After following a protocol, if the institutional committee decides that a particular level of treatment is “inappropriate,” the committee may override a patient or a family’s wishes for continued aggressive therapy and withdraw or withhold potentially lifesaving interventions [15, 16]. The patient or surrogate must be given at least 48 hours advance notice of the committee meeting and have the opportunity to attend and receive a written explanation of the committee decision [15, 16].…”

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

“…After following a protocol, if the institutional committee decides that a particular level of treatment is “inappropriate,” the committee may override a patient or a family’s wishes for continued aggressive therapy and withdraw or withhold potentially lifesaving interventions [15, 16]. The patient or surrogate must be given at least 48 hours advance notice of the committee meeting and have the opportunity to attend and receive a written explanation of the committee decision [15, 16]. If the health care providers and the patient or surrogate decision-maker cannot reach consensus, the physician must try to transfer the patient to another physician or institution [15, 16].…”

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

“…The patient or surrogate must be given at least 48 hours advance notice of the committee meeting and have the opportunity to attend and receive a written explanation of the committee decision [15, 16]. If the health care providers and the patient or surrogate decision-maker cannot reach consensus, the physician must try to transfer the patient to another physician or institution [15, 16]. If the requested treatment is considered inappropriate by the committee, and no health care provider can be found to accept the patient in transfer, than the physician and institution “are not obligated to provide life-sustaining treatment after the 10th day after the written decision” [15, 16].…”

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

“…If the health care providers and the patient or surrogate decision-maker cannot reach consensus, the physician must try to transfer the patient to another physician or institution [15, 16]. If the requested treatment is considered inappropriate by the committee, and no health care provider can be found to accept the patient in transfer, than the physician and institution “are not obligated to provide life-sustaining treatment after the 10th day after the written decision” [15, 16]. The patient or surrogate decision-maker can obtain a court-ordered extension but only if the court thinks it is likely that an alternate health care provider or health care institution can be found [15, 16].…”

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

“…If the requested treatment is considered inappropriate by the committee, and no health care provider can be found to accept the patient in transfer, than the physician and institution “are not obligated to provide life-sustaining treatment after the 10th day after the written decision” [15, 16]. The patient or surrogate decision-maker can obtain a court-ordered extension but only if the court thinks it is likely that an alternate health care provider or health care institution can be found [15, 16]. The Act does not specify the composition of the institutional ethics or medical committee that reviews potential futility cases other than stipulating that the attending physician of the case cannot be a member of the committee [15, 16].…”

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

See 4 more Smart Citations

Futility and the Care of Surgical Patients: Ethical Dilemmas

2014

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Futility has been a contentious topic in medicine for several decades. Surgery in critical or end-of-life situations often raises difficult questions about futility. In this article, we discuss the definition of futility, methods for resolving futility disputes, and some ways to reframe the futility debate to a more fruitful discussion about the goals of care, better communication between surgeon and patient/surrogate, and palliative surgical care. Many definitions of futile therapy have been discussed. The most controversial of these is “qualitative futility” which describes a situation in which the treatment provided is likely to result in an unacceptable quality of life. This is an area of continued controversy because it has been impossible to identify universally held beliefs about acceptable quality of life. Many authors have described methods for resolving futility disputes, including community standards and legalistic multi-step due process protocols. Others, however, have abandoned the concept of futility altogether as an unhelpful term. Reframing the issue of futility as one of inadequate physician–patient communication, these authors have advocated for methods of improving communication and strengthening the patient–physician relationship. Finally, we discuss the utilization of consultants who may be of use in resolving futility disputes: ethics committees, palliative care specialists, pastoral care teams, and dedicated patient advocates. Involving these specialists in a futility conflict can help improve communication and provide invaluable assistance in arriving at the appropriate treatment decision.

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Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

Section: Mechanisms For Resolving Futility Disputesmentioning

confidence: 99%

See 3 more Smart Citations

Futility and the Care of Surgical Patients: Ethical Dilemmas

2014

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Futility in Medical Decisions: The Word and the Concept

2005

HEC Forum

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Ten Common Questions (and Their Answers) on Medical Futility

Swetz

Burkle

Berge

et al. 2014

Mayo Clinic Proceedings

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The term medical futility is frequently used when discussing complex clinical scenarios and throughout the medical, legal, and ethics literature. However, we propose that health care professionals and others often use this term inaccurately and imprecisely, without fully appreciating the powerful, often visceral, response that the term can evoke. This article introduces and answers 10 common questions regarding medical futility in an effort to define, clarify, and explore the implications of the term. We discuss multiple domains related to futility, including the biological, ethical, legal, societal, and financial considerations that have a bearing on definitions and actions. Finally, we encourage empathetic communication among clinicians, patients, and families and emphasize how dialogue that seeks an understanding of multiple points of view is critically important in preventing or attenuating conflict among the involved parties.

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The Texas Advance Directives Act of 1999: An Exercise in Futility?

Cited by 6 publications

References 11 publications

Futility and the Care of Surgical Patients: Ethical Dilemmas

Futility and the Care of Surgical Patients: Ethical Dilemmas

Futility in Medical Decisions: The Word and the Concept

Ten Common Questions (and Their Answers) on Medical Futility

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