title: Futility without a dichotomy: towards an ideal physician-patient relationship.
abstract: The futility debate may be considered as an effort to provide a clear and justified borderline between physician and patient decision-making authority. In this paper we argue that the search for a definition of futility that provides physicians with a final argument in discussions about life-prolonging treatment, is misplaced. An acceptable and meaningful criterion of futility that satisfies this effort seems impossible. As a consequence, we reject a dichotomous domain of decision-making power as the starting point for definitions of futility. A good decision about withholding life-sustaining treatment should be justified from the perspectives of both physician and patient. In this light, a range of definitions of futility is still useful as it can clarify intuitions that a treatment is inappropriate.
authors.affiliation: Health Care Ethics, Office for Research, Education and Advice, Wageningen, The Netherlands. a.lelie@zonnet.nl
authors.forename: Annique
authors.initials: A
authors.lastname: Lelie
authors.forename: Marcel
authors.initials: M
authors.lastname: Verweij
mesh_terms: D003657:Decision Making / Q000941:ethics*; D015276:Health Care Rationing; D006801:Humans; D008020:Life Support Care; D018447:Medical Futility; D008962:Models, Theoretical; D010358:Patient Participation; D010360:Patient Transfer; D026684:Personal Autonomy; D010819:Physician's Role; D010817:Physician-Patient Relations / Q000941:ethics*; D017009:Professional Autonomy; D011788:Quality of Life; D016079:Refusal to Treat; D028761:Withholding Treatment