AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. June 2000, Volume 2, Number 6.

Journal Discussion

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The Illusion of Futility in Clinical Practice

Readers are referred to an article by JD Lantos et al in a 1989 issue of JAMA to discuss futility claims in the context of physicians' ethical obligations to patients.

Articles and books on bioethics continue to expand in both number and the range of topics discussed. Between 1989 and 1998, more than 4000 articles alone were published in MEDLINE-cited journals. Some of the major topics examined are the patient-physician relationship, end-of-life care, reproductive medicine, genetics, and the allocation of scarce medical resources. From these publications, we will be selecting a handful of articles and chapters, some of which reflect issues of perennial concern to physicians, others reflect more recent quandries resulting from advances in biomedical technology.

A new article or book chapter will be featured every month, accompanied by questions intended to guide readers along the path of ethical reasoning and to promote discussion.

Lantos JD, Singer PA, Walker RM, et al. The illusion of futility in clinical practice. Am J Med. 1989;87:81-84.

  1. How would these obligations be affected by disagreements between patients and physicians about the goals of therapy?
  2. Are these goals strictly medical with no other implications?
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