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Titolo:
FUTILITY AND THE COMMON COLD - HOW REQUESTS FOR ANTIBIOTICS CAN ILLUMINATE CARE AT THE END OF LIFE
Autore:
PRENDERGAST TJ;
Indirizzi:
UNIV CALIF SAN FRANCISCO,CARDIOVASC RES INST,DIV PULM & CRIT CARE MED,PROGRAM MED ETHICS SAN FRANCISCO CA 94143
Titolo Testata:
Chest
fascicolo: 3, volume: 107, anno: 1995,
pagine: 836 - 844
SICI:
0012-3692(1995)107:3<836:FATCC->2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIOPULMONARY-RESUSCITATION; PHYSICIANS REFUSAL; MEDICAL FUTILITY; AUTONOMY; ETHICS; INEVITABILITY; SURVIVAL; LIMITS; ORDERS; WEIGHT;
Keywords:
CRITICAL CARE; DECISION MAKING; ETHICS, MEDICAL; FUTILITY; LIFE SUPPORT CARE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
44
Recensione:
Indirizzi per estratti:
Citazione:
T.J. Prendergast, "FUTILITY AND THE COMMON COLD - HOW REQUESTS FOR ANTIBIOTICS CAN ILLUMINATE CARE AT THE END OF LIFE", Chest, 107(3), 1995, pp. 836-844

Abstract

The dominant approach to futility in medicine assumes that the probability and utility of medical interventions may be separated to providea quantitative (probabilistic) definition of futility. This assumption is not only misleading but also responsible for much of the confusion that futility has engendered in medical discussions. The divorce of utility from probability is the opposite of how clinicians reason: an improbable intervention looks different if it is cheap, easy, and without morbidity than if it is technology intensive, expensive, and likely to involve great pain and suffering. Futility is how physicians describe the sense of being compelled to proceed with resource intensive care for marginal benefits. Outside the intensive care unit, physiciansweigh and sometimes reject patient requests without the need to invoke futility. By examining the ways that physicians can legitimately evaluate patient requests, we can show that appeals to futility are both unnecessary and counterproductive. In cases where such appeals are unavoidable, the outpatient model suggests a process to adjudicate the competing claims of patient autonomy and physician responsibility.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 16:05:51