This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Weijer, C.
Right arrow Articles by Workman, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Weijer, C.
Right arrow Articles by Workman, S.
Related Collections
Right arrow Bioethics for Clinicians Series

Canadian Medical Association Journal, Vol 159, Issue 7 817-821, Copyright © 1998 by Canadian Medical Association

Review * Synthèse

Bioethics for clinicians: 16. Dealing with demands for inappropriate treatment

C. Weijer, P. A. Singer, B. M. Dickens and S. Workman

Demands by Patients or their Families for treatment thought to be inappropriate by health care providers constitute an important set of moral problems in clinical practice. A variety of approaches to such cases have been described in the literature, including medical futility, standard of care and negotiation. Medical futility fails because it confounds morally distinct cases: demand for an ineffective treatment and demand for an effective treatment that supports a controversial end (e.g., permanent unconsciousness). Medical futility is not necessary in the first case and is harmful in the second. Ineffective treatment falls outside the standard of care, and thus health care workers have no obligation to provide it. Demands for treatment that supports controversial ends are difficult cases best addressed through open communication, negotiation and the use of conflict-resolution techniques. Institutions should ensure that fair and unambiguous procedures for dealing with such cases are laid out in policy statements.


This article has been cited by other articles:


Home page
 NDT PlusHome page
E. Gabbay and K. B. Meyer
Identifying critically ill patients with acute kidney injury for whom renal replacement therapy is inappropriate: an exercise in futility?
NDT Plus, April 1, 2009; 2(2): 97 - 103.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
A. S. Slutsky and L. D. Hudson
Care of an Unresponsive Patient with a Poor Prognosis
N. Engl. J. Med., January 29, 2009; 360(5): 527 - 531.
[Full Text] [PDF]

Home page
 QJMHome page
S. Workman
Cardiopulmonary resuscitation: charting a course for the future
QJM, October 1, 2006; 99(10): 711 - 715.
[Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
P. S. Mueller, C. C. Hook, and K. C. Fleming
Ethical Issues in Geriatrics: A Guide for Clinicians
Mayo Clin. Proc., April 1, 2004; 79(4): 554 - 562.
[Abstract] [PDF]

Home page
 CMAJHome page
C. Frank, D. K. Heyland, B. Chen, D. Farquhar, K. Myers, and K. Iwaasa
Determining resuscitation preferences of elderly inpatients: a review of the literature
Can. Med. Assoc. J., October 14, 2003; 169(8): 795 - 799.
[Abstract] [Full Text]