The problem of futility and care for AIDS-patients. A European perspective.
Int Conf AIDS 1993 Jun 6-11; 9:124 (abstract no. WS-D21-2) Sahm SW, Dancygier H; Second Department of Medicine, Stadtische Kliniken Offenbach, J.W. Goethe University, Frankfurt/Main, Germany.
Physicians are not obliged to offer futile treatment. The term futility itself has prompted major concern in the literature on ethics in medicine. Its meaning has been questioned recently. Since AIDS patients often are well educated and well informed about their disease, there may be a quarrel about who has to decide what futility means in a certain case. Special reference is made to intensive care for AIDS-patients and to treatment with new drugs while clinical trials are still under way. Estimation of futility serves as a factor to prevent patients from aggressive treatment and as a means for resource allocation. In this presentation it is argued that futility first of all is a medical judgement. Every medical decision involves scientific and ethical aspects as well. Futility is one condition amongst others that constitute a medical decision. It can never be seen as mere statistical probability. In case of AIDS it encompasses scientific data (e.g. immunology and probability of certain treatments), general health status of the patient as well as patients' mental capacity. It will be shown that the notion of futility signifies the contribution of the physician as a specialist to a medical decision, that should be made in concordance with patients' preferences. In case of AIDS patients preferences should be discussed early in the course of the disease to prevent dilemmas in advance.
Keywords: AEGIS, Medical Futility, Acquired Immunodeficiency Syndrome, Ethnic Groups, Probability, Human, ICA9 930606
WSD212
