An Exploration of Medical Professionals' Perspectives on Medical Futility

Saturday, 7 November 2015

Ming Yi Hsu, PhD, MSc, RN, LPN
School of Nursing, Chung Shan Medical University, Taichung, Taiwan

An exploration of medical professionals’ perspectives on medical futility

Background: Advanced medical technology helps extend the lives of critical patients. Under certain circumstances, medical interventions only prolong patients’ life without ensuring an acceptable quality of life. Therefore, futile treatments are considered wasteful from the perspective of the national health insurance system. Because the term “medical futility” is used in many different ways, it is difficult to define and, therefore, also difficult to assess.

Purpose: The purpose of this research was to explore nurses’ and physicians’ perspective on medical futility.

Methods: A phenomenology approach and purposive sampling was applied. Participants were 7 Intensive Care Unit (ICU) nurses working in medical centers in central Taiwan who had more than one year working experience that included experience taking care of critical patients. Following Jovchelovitch and Bauer (2000), a 4-phase narrative interview procedure was used, and data analysis was applied using the Colaizzi (1978) method. Five physicians who worked at ICUs or had experience taking care of critical patients were invited to participate in one-to-one interviews. After the physicians had fully expressed their perspectives on medical futility, medical futility case stories which had been developed from previous interviews with ICU nurses were introduced to the physicians. Four major themes emerged, including definition of medical futility, types of medically futile patients, ethical considerations regarding medical futility, and professional positions on medically futile treatment and nursing care. The trustworthiness of the study was examined using Lincoln and Guba (1985) principles.

Contributions: The results of this research could help medical professionals to understand medical futility in clinical situations. The case stories developed from the study’s narrative interviews will also be of value in clinical health care, multi-professional communication, and life-ethics education.