Point: The Texas advance directives act effectively and ethically resolves disputes about medical futility.

摘要

This clinical scenario is familiar to physicians, nurses, and other health-care professionals who treat seriously ill patients. Although we prefer the role of Asclepios, in some cases we take on the role of the Danaides attempting to fill a leaking cistern. Our patient cannot recover enough to live free from the hospital, is either suffering or unable to appreciate any joy in being alive, and cannot die easily or peacefully without permission. We conclude that further aggressive treatment is futile. Most surrogates will agree and may have come to the same sad conclusion before the physician. On occasion, however, that permission is not forthcoming, as in this case, and we no longer face the problem of medical futility; we face a medical futility conflict.