Attempts to establish a consensus definition of ‘medical futility’ have been unsuccessful. Given this, healthcare institutions in the US have been left to establish their own ‘futility’ or ‘inappropriate treatment’ policies or guidelines. This talk will examine one large trauma center’s recent transition from a minimally value-laden futility policy (i.e., a physiological futility-based policy) to a more expansively value-laden policy (i.e., based on expected survivability to discharge). This transition was primarily made in response to advances in the development and utilization of life-sustaining technology (including ECMO) that have led to a significant increase in so-called ‘bridge-to-nowhere’ patients whose lives may be sustained for prolonged periods in the ICU setting but are who are unlikely to be able to survive their hospitalization.

 

Bioethics and Medical Humanities Grand Rounds provides a monthly forum for teaching participants to resolve cases based on the best ethical practices. Bioethics and Medical Humanities Grand Rounds also provides information on any legislative changes that occur so that clinicians are ready to implement them. The Center for Bioethics and Medical Humanities is the only clinical ethics center in Wisconsin. The faculty are leaders in clinical ethics and set the agenda for clinical ethics practice in Southeastern Wisconsin.

 

Key Words: Bioethics, Clinical Ethics, Health Care Ethics, Medical Ethics, Medical Humanities