Flashcards on Medical Futility and End-of-Life Care Ethics

Medical Futility and End-of-Life Care Ethics Explained for Students

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How does the text define 'dying' or 'actively/imminently dying' in clinical terms?

Clinical conditions indicating that the patient's organ systems are disintegrating rapidly and irreversibly, with death expected within hours (often c

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End-of-life Care and Medical Futility

8 cards

Card 1

Question: How does the text define 'dying' or 'actively/imminently dying' in clinical terms?

Answer: Clinical conditions indicating that the patient's organ systems are disintegrating rapidly and irreversibly, with death expected within hours (often c

Card 2

Question: When a patient is 'dying' as defined in the text, how do indications for medical intervention change?

Answer: Indications change significantly: many interventions become nonindicated because they offer no positive physiological effect or cannot reverse the dec

Card 3

Question: What clinical features in Mr. Care's case indicate he is dying?

Answer: Multisystem organ failure with very low blood pressure (60/40 mm Hg) unresponsive to pressors/volume, arterial oxygen saturation 45%, anuria, rising c

Card 4

Question: What is 'physiologic futility' as used in the text?

Answer: A situation in which physiological systems have deteriorated so drastically that no known medical intervention can reverse the decline; interventions

Card 5

Question: According to the text, when is it ethically justifiable for physicians to recommend withdrawing interventions?

Answer: When physiologic futility is present—i.e., the patient is dying and interventions have no positive physiological effect—physicians may ethically recom

Card 6

Question: What exception does the text state when recommending withdrawal of life-sustaining interventions for a dying patient?

Answer: Interventions intended to provide comfort may be continued; other life-sustaining measures that have no physiological benefit are no longer indicated.

Card 7

Question: How does the house officer in the case use the term 'futile,' and how does the text comment on that usage?

Answer: The house officer uses 'futile' to mean the interventions would be ineffective in a dying patient. The text notes this is a noncontroversial shorthand

Card 8

Question: If a family requests continued interventions despite physiologic futility, what does the text suggest?

Answer: The text indicates there is a discussion (in Section 1.2.2) about handling family requests for continued interventions when physiologic futility exist