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June 1992

Medical Futility: Who Decides?

Author Affiliations

Department of Medical History and Ethics, SB-20; Division of Gerontology and Geriatrics University of Washington Seattle, WA 98195

Arch Intern Med. 1992;152(6):1140-1144. doi:10.1001/archinte.1992.00400180012002

Futility is hardly a novel idea in medicine. Its roots in ancient medicine go back at least to the fifth-century BC physician Hippocrates.1,2 Yet debates over its meaning and ethical implications are surfacing with growing frequency. Increasingly, physicians seek to limit the lengths to which they must go to sustain the lives of patients who have lost the ability for conscious, interactive, and meaningful functioning. For example, in a recent case at Hennepin County (Minnesota) Medical Center, physicians invoked medical futility to support withdrawal of life-sustaining treatments from a patient, Helga Wanglie, who was irreversibly respirator dependent and unconscious (S. Miles, MD, written communication, March 22, 1991). Michael Belzer, MD, Medical Director of Hennepin County Medical Center, stated that although he sympathized with family members who insisted that everything possible be done, "We don't feel that physicians are obligated to provide inappropriate medical treatment that is not in the