Medical futility in the natural attitude

Medical futility has a long history going back to Plato but continues to be a controversial topic. Patients, families, and health professionals are faced with decisions about which treatments and interventions may be futile, but such questions as who decides; how do competing values get resolved; what value is placed on human life; how are decisions balanced according to reason and, in some circumstances, faith; and who decides effect, benefit, and burdens of treatments are often difficult to answer. The naïve reality of medical futility is explored in the natural attitude to expose presumptions and facts related to both physiologic (fact-based) and evaluative (value-based) futility components. Highlights from the bioethical and clinical literature, a review of 3 landmark cases, and implications for nursing practice are presented. This natural attitude description could serve as what ought to be bracketed for a future phenomenology.