PURPOSE This exploratory study used a set of four obstacle constructs derived from both the existing literature and our earlier work to describe the diverse end-of-life scenarios observed for a group of residents in a long-term care facility. DESIGN AND METHODS Data from a retrospective chart review and both quantitative and qualitative methods of data collection and analysis were used to exa...

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...

Concerns over limited medical equipment and resources, particularly in intensive care units (ICUs), have raised the issue of medical futility. Medical futility draws a contrast between physician's authority and patients' autonomy and it is one of the major issues of end-of-life ethical decision-making. The aim of this study was to review medical futility and its challenges. In this systematized...

"Futility" is a word which means the absence of benefit. It has been used to describe an absence of utility in resuscitation endeavours but it fails to do this. Futility does not consider the harms of resuscitation and we should consider the balance of benefit and harm that results from our resuscitation endeavours. If a resuscitation is futile then any harm that ensues will bring about an unfa...

See related article, pages 2410–2414. In this issue, Palesch et al 1 discuss the single-arm, phase II futility study design and illustrate how its use might have avoided 3 large (and costly) but negative phase III therapeutic trials for ischemic stroke patients. The authors offer strong arguments to support their conclusion that use of this design as a strategy in phase II development “could pe...

For a long-term randomized clinical trial, it has become a well-accepted practice to include interim analyses in trial protocols. In addition to design an efficacy monitoring plan, investigators often develop a futility monitoring plan as well to prevent continuing a trial that has little chance to demonstrate treatment efficacy. Conditional power is the probability that the final analysis will...