Iranian Journal of Medical Ethics and History of Medicine

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When medical treatment is futile, the physicians must refrain from treating patients, and this can lead to serious and stressful problems. In this paper, in order to facilitate ethical decision making relevant literatures have been reviewed. This review article aimed to explaining the different clinical forms of futile treatment, and exploring theoretical and practical dimensions of futility. The first problem in this field is ambiguity in the definition of futility. The next problem is determining the practical criteria and attributing the meaning of futility to particular treatments. This ambiguity is partly due to different perspectives about the goal of treatment, and variations in physicians' and patients’ values and also disagreements regarding the person who should have the right to make decisions ultimately. It may also be related to finances and immoral motives. The third problem is some practical conflicts the most notable are futile care, requested by the patient and the sanctity of life, especially in the concern of religious considerations. In this regard, several definitions have been proposed for the futile treatment. Studies indicate that requesting futile care is often due to emotional problems or lack of trust a case that requires the physician’s tact to resolve and rarely is resolved by rule. Another serious problem that is regarding to end of life cares, especially in the context of religious views, is the necessity of life saving, that is closely related to the inactive euthanasia. This can be solved by giving priority to more important issues such as health budget constraints.

Keywords: futility, futile care, autonomy, inactive euthanasia, sanctity of life

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