Does professional autonomy protect medical futility judgments?

Area of Science:

• Medical Ethics
• Bioethics
• Healthcare Policy

Background:

• Medical futility judgments are prevalent despite controversy.
• Hospital policies and professional guidelines support these judgments.
• Disagreements arise when healthcare professionals (HCPs) and patients/families differ on treatment value.

Purpose of the Study:

• To critically analyze the argument of professional autonomy in medical futility cases.
• To examine three distinct versions of the professional autonomy argument.
• To determine if professional autonomy can ethically override patient/family values in futility determinations.

Main Methods:

• Philosophical analysis of the professional autonomy argument.
• Distinguishing and evaluating three specific versions of the argument.
• Examining objections related to patient values and resource allocation.

Main Results:

• None of the three versions of the professional autonomy argument successfully resolves the ethical conflict.
• Futility determinations inherently involve subjective value judgments.
• Patient-centered values, not resource considerations, should guide futility judgments.

Conclusions:

• Professional autonomy does not provide a sufficient ethical basis for HCPs to unilaterally refuse treatments deemed futile.
• Futility judgments should prioritize patient values, surrogate decisions, and family perspectives.
• Resource considerations should not influence patient-centered futility determinations.