Age as a deciding factor in the consideration of futility for a medical intervention in patients among internal medicine physicians in two practice locations.
OBJECTIVE
This study explores physicians' concepts of futility and use of age as a deciding factor in considering medical futility in clinical interventions.


METHODS
Survey.


METHODS
Five academic hospitals in the United States.


METHODS
Participants were 355 internal medicine physicians, including 162 residents, 98 fellows, and 95 attending physicians.


METHODS
Anonymous questionnaire in which respondents were asked to define futility and to rate patient scenarios as futile or not, unaware that these were pairs of patient scenarios with similar clinical severity and treatment, but different age.


RESULTS
Forty-five percent (n = 159) of physicians used the most accepted definition of futility in the literature: "a therapy that will not benefit the patient in attaining a specific goal." Physicians rated patient scenarios as futile for 58% of elder (> or =65 years) and for 59% of nonelder (<65 years) cases (P = .21). By training level, resident physicians rated more elder cases as futile (60%) than fellow/attending physicians (56%, P = .03). Rating of medical futility did not differ by practice location (59% in Missouri and 59% in Puerto Rico, P = .13).


CONCLUSIONS
Physicians did not use age as a factor in deciding the futility of a medical intervention. In patient scenarios with comparable clinical severity of illness, medical interventions were similarly rated as futile in elder and nonelder persons. Less-experienced physicians (residents) were more likely to rate elder cases as futile compared with experienced physicians (attending/fellows).
Cruz-Oliver
Dulce M
DM
Saint Louis University, MO 63104, USA. dcruzoli@slu.edu
Thomas
David R
DR
Scott
Jeffrey
J
Malmstrom
Theodore K
TK
De Jesus-Monge
Wilfredo E
WE
Paniagua
Miguel A
MA
D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003657:Decision Making; D006801:Humans; D007388:Internal Medicine; D018447:Medical Futility; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D011365:Professional Practice Location; D011795:Surveys and Questionnaires; D014481:United States