Futility, conscientious refusal, and who gets to decide

Area of Science:

• Medical Ethics
• Healthcare Policy
• Bioethics

Background:

• Discussions on medical futility often focus on defining when a procedure is futile, lacking universal consensus.
• Existing policies address disputed futility cases by assigning decision-making authority to healthcare providers when consensus with patients or surrogates cannot be reached.

Purpose of the Study:

• To provide a procedural answer to the question of who holds moral authority in disputed medical futility cases.
• To support the argument that healthcare providers should have the final say in such disputes.

Main Methods:

• Analysis of existing medical futility policies.
• Ethical argumentation focusing on the concept of conscientious refusal.

Main Results:

• The study supports policies where healthcare providers decide disputed medical futility cases.
• It posits that providers possess a right of conscientious refusal applicable to futility decisions.

Conclusions:

• Healthcare providers should be granted the moral authority to decide disputed medical futility cases.
• This authority is justified by a procedural right of conscientious refusal, irrespective of the absolute correctness of their futility assessment.