Using the “F Word" in the ICU: Futility and Its Ethical Conundrums in Critical Care

Tuesday, January 23, 2024

3:45 PM – 4:45 PM MT

Location: West-301BC

CE: 1.0

Concurrent Session Moderator(s)

Preeti John, MD, MPH, HEC-C (she/her/hers)

Surgeon, Intensivist, Health Care Ethics Consultant
Veterans Affairs Maryland Health Care System
Baltimore, MD
Mindy Dickerman, MD, (she/her/hers)

Director of Education, Co-Chair of Ethics Committee
Nemours/Alfred I. DuPont Hospital for Children
Wilmington, Delaware

This session will explore clinical and legal definitions of medical futility across the spectrum of neonatal, pediatric, and adult critical care, including the related concepts of nonbeneficial and potentially inappropriate therapies. Speakers will examine the development of hospital policies concerning futility and the benefits and disadvantages of implementing these policies in clinical practice. Intensivists will be able to analyze factors that may provoke intractable conflict between the medical team and the patient and family at end of life and use strategies to avoid such conflicts. Examples of cases from the media will be discussed.

Learning Objectives:

Examine the concept of futility and critique its applicability in critical care
Discuss the evolution of hospital policy on futility through examination of state laws and landmark cases that have impacted these policies
Outline the differences in approach to futility and end of life across the spectrum of ages
Assess risks for intractable disagreement with patients and families at end of life and outline tools to address such conflicts

Presentations:

Is the Unilateral DNR Ever Ethical?
One-Size Advance Directives Do Not Fit All
Futility Versus Miracles: Responding to Faith-Based Decision-Making