Sun 15 Sep, 2013 08:50 am
September 11, 2013, 10:16 am
Futile Care at Life’s End
By NICHOLAS BAKALAR
Researchers studying critical care in four intensive care units at large medical centers report that almost 11 percent of patients received care that their doctors considered futile.
Over three months, researchers gave daily questionnaires to I.C.U. physicians offering a list of reasons treatment could be called futile: burdens grossly outweigh benefits, patient will not survive outside the I.C.U., patient is brain-dead, treatment cannot achieve the patient’s goals, or death is imminent. The results appear in JAMA Internal Medicine.
Of 1,316 patients, 123 received treatment that could regarded as futile; 11 other patients were also given useless treatment, but only on the day they were moved to hospice care. The estimated cost of the futile care was $2.6 million.
About 68 percent of the patients who received futile treatment died in the hospital, and 16 percent died within six months of discharge. The survivors remained in severely poor health.
“There has to be far better communication between patients and doctors, families and doctors, patients and families,” said the senior author, Dr. Neil S. Wenger, a professor of medicine at the University of California, Los Angeles. “This ought to be a wake-up call that patients are at times receiving advanced medical treatment that is not benefiting them. It’s costing patients in terms of a prolonged death, and the families in terms of acting on inappropriate hope.”