This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Nancy S. Jecker, PhD; Robert A. Pearlman, MD, MpH
Seattle, Wash

Arch Intern Med. 1992;152(12):2506.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

We appreciate the thoughtful letter of Matz highlighting the importance of the attending physician's involvement in all deliberations about medical futility. However, we do not agree with his blanket conclusion that "the ultimate decision" concerning futility rests with the attending physician.

We wish to reinforce the concept that there are circumstances in which a patient (or surrogate) can legitimately trump even an attending physician's judgment of qualitative futility. This would occur in cases where the individual physician's judgment is not supported by broader community standards. One kind of situation occurs when community consensus does not exist about whether the quality of a treatment outcome is acceptable. In such a situation, a patient's request for treatment cannot be overridden by an attending physician's claim that treatment is futile. An example is a conscious patient who is ventilator dependent. A second kind of situation occurs when an attending physician regards . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?