A Preventive Ethics Approach to Counseling Patients About Clinical Futility in the Primary Care Setting
David J. Doukas, MD;
Laurence B. McCullough, PhD
Arch Fam Med. 1996;5(10):589-592.
Given the current themes of futility and managed care in medicine and bioethics, the primary care setting needs to account for how to address futility. We argue for applying the concept of clinical futility to primary care medicine. A preventive ethics approach directs the primary care physician to explain and counsel against futile interventions, with a negotiation strategy for circumstances of disagreement. These efforts will require primary care physicians to concentrate their efforts on education, negotiation, and enhanced trust in their patient relationships. Using a preventive ethics approach in these circumstances, the physician can better protect the interests of the patient by avoiding nonbeneficial interventions, especially those that also are potentially harmful.
From the Department of Family Practice and the Program in Society and Medicine, University of Michigan, Ann Arbor (Dr Doukas); and the Center for Medical Ethics and Public Policy, Baylor College of Medicine, Houston, Tex (Dr McCullough).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Conditions and consequences of medical futility--from a literature review to a clinical model
Lofmark and Nilstun
J. Med. Ethics 2002;28:115-119.
| FULL TEXT
The Rise and Fall of the Futility Movement
Helft et al.
Ethical Theories and Clinical Practice: One Family Physician's Approach
Arch Fam Med 1999;8:342-344.
| FULL TEXT
LETTERS TO THE EDITOR
Arch Fam Med 1997;6:422-422.