title: Medically Inappropriate or Futile Treatment: Deliberation and Justification.
abstract: This paper reframes the futility debate, moving away from the question "Who decides when to end what is considered to be a medically inappropriate or futile treatment?" and toward the question "How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?" It offers a pragmatist moral epistemology that provides us with (1) a clear justification of why it is important to take best standards, norms, and physician judgment seriously and (2) a clear justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms.
authors.affiliation: University of Toronto, Toronto, Ontario, Canada University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Center for Bioethics, Harvard Medical School, and Division of Critical Care Medicine, Boston Children's Hospital, Boston, Massachusetts, USA cheryl.misak@utoronto.ca.
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Misak
authors.affiliation: University of Toronto, Toronto, Ontario, Canada University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Center for Bioethics, Harvard Medical School, and Division of Critical Care Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: White
authors.affiliation: University of Toronto, Toronto, Ontario, Canada University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Center for Bioethics, Harvard Medical School, and Division of Critical Care Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Truog
mesh_terms: D003657:Decision Making; D026689:Ethical Analysis; D005190:Family; D006801:Humans; D007600:Judgment; D018447:Medical Futility / Q000941:ethics*; D009014:Morals; D017008:Negotiating; D010686:Philosophy, Medical; D010819:Physician's Role; D057766:Policy; D013727:Terminal Care / Q000941:ethics; D028761:Withholding Treatment / Q000941:ethics
keywords: futility; medically inappropriate treatment; pragmatism