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Futile Medication for Terminally Ill Cancer Patients

Posted Jul 26 2009 10:31pm
Canadian and Brazilian researchers published an article in the June 2009 Supportive Care in Cancer finding that "one-fifth of cancer patients at the end of life use medications that lack benefit in the short term."

This might be a good time to provide a taxonomy of the medical futility issue. While I focus primarily on medical futility disputes, those are just one subset of the larger class. There are at least four other situations that present problematic futility issues:
  1. The physician willingly accedes to the surrogate's request for non-beneficial treatment (both physician and surrogare want to continue)
  2. The physician reluctantly accedes to the surrogate's request for non-beneficial treatment (physician would prefer to stop, but either thinks its the surrogate's call ot does not want to create conflict)
  3. The surrogate/patient willingly accedes to the physician's recommendation for non-beneficial treatment (where at least the surrogate does not realize it is non-beneficial)
  4. The surrogate/patient reluctantly accedes to the physician's recommendation for non-beneficial treatment (perhaps to avoid the guilt of deciding otherwise)
In short, adamant surrogates use the threat of litigation to drive the provision of some non-beneficial treatment. But the far bigger driver of non-beneficial treatment is physicians.
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