End-of-life decision making: The concept of ‘futility’ and acting in the best interests of the patient

Resumo

End-of-life decision making can be a morally and technically arduous and legally risky task. In practice, the determination of whether a particular treatment is futile is inherently subjective. Moreover, differing goals and expectations of clinicians compared to those of a patient’s guardian, family and friends may mean that that determination can be emotionally charged and assessed from differing perspectives. This paper will attempt to define the concept of ‘futility’ in the end-of-life care context and rationalise its application in the common law context. It discusses this legal concept by reference to guidance provided by courts and recent research in this space. It also outlined the best interests test by discussing its definition, scope, obligations, and limitations. This paper provides guidance to clinicians in a role which may ever require the determination of life-ending medical action.