Wednesday, March 3, 2010

Analyzing "Is it Always Wrong to Provide Futile Care?"

Rosemary Flanigan
March 3, 2010

Robert Truog's "Is it always wrong to provide futile care?" in the February 11th New England Journal of Medicine prompted some excellent discussion at the Center for Practical Bioethics.

(Link: Murky path on deciding care at the end, New York Times, Feb 22)

Although "always" and "never" questions allow wriggle room, I spent time wondering how an ethical analysis helped here.

It is easy to set up the analysis; from moral principles one can see the conflict between beneficence and nonmaleficence. The arguments for the priority of nonmaleficence in this case simply flows off the tongue. Or, if you are arguing in a utilitarian framework, it is simple to show the strength of the consequences of non-intervention on the ultimate outcome.

But here, argument doesn't convince. I can see Dr. Truog even agreeing that your argument is stronger than his, yet he justifies acting as he did. So what is the point of argument?

Ethics committee members make compelling arguments in case consultations that are often rejected by patients, families or providers.




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