Experts' attitudes towards medical futility: an empirical survey from Japan.
BACKGROUND The current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility.


METHODS
To examine the attitudes of the Japanese experts in the fields relevant to medical futility a questionnaire survey was conducted among the members of the Japan Association for Bioethics. A total number of 108 questionnaires returned filled in, giving a response rate of 50.9%. Among the respondents 62% were healthcare professionals (HCPs) and 37% were non-healthcare professionals (Non-HCPs).


RESULTS
The majority of respondents (67.6 %) believed that a physician's refusal to provide or continue a treatment on the ground of futility judgment could never be morally justified but 22.2% approved such refusal with conditions. In the case of physiologically futile care, three-quarters believed that a physician should inform the patient/family of his futility judgment and it would be the patient who could decide what should be done next, based on his/her value judgment. However more than 10% said that a physician should ask about a patient's value and goals, but the final decision was left to the doctor not the patient. There was no statistically significant difference between HCPs and Non-HCPs (p = 0.676). Of respondents 67.6% believed that practical guidelines set up by the health authority would be helpful in futility judgment.


CONCLUSIONS
The results show that there is no support for the physicians' unilateral decision-making on futile care. This survey highlights medical futility as an emerging issue in Japanese healthcare and emphasizes on the need for public discussion and policy development.
Bagheri
Alireza
A
Graduate School of Law, Kyoto University, Yoshida, Sakyo-ku, 606-8501 Kyoto, Japan. bagheri@research.mbox.media.kyoto-u.ac.jp.
Asai
Atsushi
A
Ida
Ryuichi
R
D000368:Aged; D001290:Attitude; D001291:Attitude of Health Personnel; D003657:Decision Making / Q000941:ethics; D034462:Dissent and Disputes; D026822:Ethicists; D028741:Ethics Committees, Clinical; D005190:Family; D017408:Guidelines as Topic; D006801:Humans; D007564:Japan; D008020:Life Support Care / Q000523:psychology; D018447:Medical Futility / Q000941:ethics* / Q000523:psychology*; D026706:Paternalism; D018458:Persistent Vegetative State; D026684:Personal Autonomy; D010819:Physician's Role; D011788:Quality of Life; D016079:Refusal to Treat / Q000941:ethics; D011795:Surveys and Questionnaires; D028761:Withholding Treatment / Q000941:ethics