title: The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis.
abstract: The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is first determined by medicine, in order for the determination to meet legal criteria, it must be subject to review. The hope is that through a review process that meets legal criteria, the issue can be resolved without the need for court proceedings. If resolution cannot be obtained through this process, surrogates still have the right to seek court intervention. This issue is of relevance and importance in critical care nursing because of the role and position of critical care nurses, who have direct contact with patients and patients' families, the potential for moral distress in cases of possibly futile treatment, and the expanding roles of nurses, including critical care nurses and advanced practice nurses, in management and policy development.
authors.affiliation: Jocelyn A. Olmstead is in the online master's of nursing-family nurse practitioner program at Drexel University, Philadelphia, Pennsylvania, and works as a staff nurse in the emergency department at Johns Hopkins Bayview in Baltimore, Maryland.|Michael Dahnke is a bioethicist and adjunct instructor in the School of Nursing at the College of New Rochelle, New Rochelle, New York, and adjunct instructor in the philosophy department at the College of Staten Island, New York, New York.
authors.forename: Jocelyn A
authors.initials: JA
authors.lastname: Olmstead
authors.affiliation: Jocelyn A. Olmstead is in the online master's of nursing-family nurse practitioner program at Drexel University, Philadelphia, Pennsylvania, and works as a staff nurse in the emergency department at Johns Hopkins Bayview in Baltimore, Maryland. mdahnke@cnr.edu.|Michael Dahnke is a bioethicist and adjunct instructor in the School of Nursing at the College of New Rochelle, New Rochelle, New York, and adjunct instructor in the philosophy department at the College of Staten Island, New York, New York. mdahnke@cnr.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Dahnke
mesh_terms: D016223:Advance Directives; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D000066491:Clinical Decision-Making / Q000941:ethics*; D003422:Critical Care / Q000592:standards / Q000639:trends; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007362:Intensive Care Units; D033183:Interdisciplinary Communication; D018447:Medical Futility / Q000941:ethics*; D010348:Patient Care Team / Q000458:organization & administration; D014481:United States