The emergence of new obstetrical and neonatal technologies, as well as more aggressive clinical management, has significantly improved the survival of extremely low birth weight (ELBW) infants. This development has heightened concerns about the limits of viability. ELBW infants, weighing less than 1,000 grams and no larger than the palm of one’s hand, are often described as “miracles” of late t...

OBJECTIVES This study explores physicians' concepts of futility and use of age as a deciding factor in considering medical futility in clinical interventions. DESIGN Survey. SETTING Five academic hospitals in the United States. PARTICIPANTS Participants were 355 internal medicine physicians, including 162 residents, 98 fellows, and 95 attending physicians. MEASUREMENT Anonymous question...

n engl j med 357;1 www.nejm.org july 5, 2007 was an 18-month-old boy who had Leigh’s disease, a progressive and fatal neurometabolic disorder. He had been on life support in the intensive care unit for 5 months. The hospital had invoked the Texas Advance Directives Act, which authorized it to withdraw life support if an ethics committee had determined that further life support was medically ina...

he past few years in health care have been a story of extraordinary turbulence. After decades of uncontrolled cost escalation, the businesses and governments that directly pay for most health care finally mandated a fiscal restraint that, in the early 1990s, launched in earnest the upheaval known as “managed care.” One major result has been the replacement of such values as, “If it might help a...

OBJECTIVE To investigate cases of potential medical futility treatment in intensive care unit (ICU). MATERIALS AND METHODS Retrospective review of 1567 charts of patients treated during the three-year period (2012 - 2014) in the ICU of the University Hospital Centre Split, Croatia, was conducted. More detailed analysis of the deceased patients' (n=429) charts was performed to identify cases o...

UNLABELLED BACKGROUND The current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility. METHODS To examine the attitudes of the Japanese experts in the fields relevant to medical futility a questionnaire survey was conducted among the members of the Japan ...