FORCES IN THE EVOLUTION OF FUTILE TREATMENT

    "With all that can now be accomplished in medicine, why do patients die an undesirable, ‘bad,’ technology-driven death within systems that otherwise deliver the best health care in the world? The forces that have led to the futile use of ineffective medical diagnostic tests, treatments, & interventions include: (a) the imbalance of scientific knowledge, with extensive knowledge of benefits but typically little knowledge of the limitations of rapidly evolving medical technology; (b) inadequate training of healthcare workers for providing palliative care in a setting of increasing demands & training to rapidly apply highly technical skill to ever increasing numbers of patients; (c) cultural obstacles to accepting death as a natural part of life; (d) economic forces that promote high-tech futile treatment & inadequately support alternative palliative care; (e) a legal climate that promotes unfounded concerns about liability for not ‘doing everything’ & inadequately supports policies that guard against medically futile treatments; (f) continued debate by medical, legal, & ethical leadership over accurate recognition & management of medical futility & the related disagreement over appropriate allocation of health care resources.” [1]