The medical futility controversy: bioethical implications for the critical care nurse.
Medical futility is a recent, complex bioethical issue. There is disagreement about how futility should be defined and who should be involved in futility decisions when an impasse exists between the patient/family and the physician. Bioethical discussions about Quinlan and Cruzan of the past have been replaced with the Wanglie, Baby K, and Linares cases--all of which involved critical care settings. Nurses often are involved in the debate and encounter ethical conflicts. Cost-containment, managed care, scarce resource allocation, and care due the elderly have fueled the debate. Key issues and their importance for critical care nurses will be reviewed.
Cogliano
J F
JF
Department of Nursing, College of Health Professions, Towson University, Maryland, USA.
D003220:Conflict, Psychological; D003422:Critical Care / Q000331:legislation & jurisprudence / Q000592:standards*; D004993:Ethics, Nursing; D006801:Humans; D018447:Medical Futility; D009741:Nursing Staff, Hospital / Q000331:legislation & jurisprudence / Q000592:standards*; D017410:Practice Guidelines as Topic; D014481:United States