Separate thread for Ethics Section members to share articles related to the 'medical futility' topic. Feel free to share any article(s) you think will be appreciated by SCCM colleagues! (Adult + Pediatric)
Prior SCCM Publications:
1. Consensus statement of the Society of Critical Care Medicine's Ethics Committee regarding futile and other possibly inadvisable treatments. Crit Care Med. 1997 May;25(5):887-91. doi: 10.1097/00003246-199705000-00028. PMID: 9187612.
2. Bosslet GT, Pope TM, Rubenfeld GD, Lo B, Truog RD, Rushton CH, Curtis JR, Ford DW, Osborne M, Misak C, Au DH, Azoulay E, Brody B, Fahy BG, Hall JB, Kesecioglu J, Kon AA, Lindell KO, White DB; American Thoracic Society ad hoc Committee on Futile and Potentially Inappropriate Treatment; American Thoracic Society; American Association for Critical Care Nurses; American College of Chest Physicians; European Society for Intensive Care Medicine; Society of Critical Care. An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units. Am J Respir Crit Care Med. 2015 Jun 1;191(11):1318-30. doi: 10.1164/rccm.201505-0924ST. PMID: 25978438.
3. Kon AA, Shepard EK, Sederstrom NO, Swoboda SM, Marshall MF, Birriel B, Rincom F. Special Article: Defining Potentially Inappropriate Treatment: A Policy Statement from the SCCM Committee on Ethics. Critical Care Medicine 44(9): 1769-1774. September, 2016. IF 6.312
Couple of other publications by members of the writing workgroup (Douglas White MD, Thaddeus Pope JD) that are worth reading:
1) 'How Seeking Transfer Often Fails to Help Define Medically Inappropriate Treatment'
White DB, Pope TM. How Seeking Transfer Often Fails to Help Define Medically Inappropriate Treatment. Hastings Cent Rep. 2024 Mar;54(2):2. doi: 10.1002/hast.1572. PMID: 38639166.
i) "if potential receiving hospitals answer that they will not accept a patient in transfer, they should be required to provide their reasons."
ii) "if a potential receiving hospital responds that they will not accept the patient and they do not believe that the requested treatments violate community standards, not only
should this evidence be documented in the patient's medical record, but also the physicians and ethics committee at the treating hospital should reexamine the ethics of the case in light of this new information."
2) White DB, Pope TM. The courts, futility, and the ends of medicine. JAMA. 2012 Jan 11;307(2):151-2. doi: 10.1001/jama.2011.1990. PMID: 22235083; PMCID: PMC3530837.
"Patients have an interest in receiving care consistent with their values. Physicians have an interest in not being compelled to act against their beliefs about how
to best respect human dignity near life's end. Society has important interests in protecting individual rights and ensuring the fair allocation of scarce medical resources. When the interests of each party are correctly understood, it is clear that such decisions are not purely "medical" decisions; thus, unilateral clinician decision making is problematic.
Courts have special expertise to adjudicate between parties in the face of conflicts about fundamental interests. Courts fulfill this social role in part by ensuring a fair process of decision making."
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Preeti R. John MD, MPH, FACS, FCCM, HEC-C
Surgeon, Intensivist, Certified Healthcare Ethics Consultant,
Veterans Affairs Maryland Health Care System,
Clinical Associate Professor, Dept. of Surgery,
University of Maryland School of Medicine,
Baltimore, MD
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