Kite Suzanne, Wilkinson Stephen
Palliative Medicine at the Leeds General Infirmary and Cookridge Hospitals, Yorkshire, Leeds, UK.
Lancet Oncol. 2002 Oct;3(10):638-42. doi: 10.1016/s1470-2045(02)00878-1.
The concept of futility has often been invoked to justify abstention from treatment and decisions such as 'do not attempt resuscitation' (DNAR). In this capacity, futility has played an important part in the development of several sets of official clinical guidelines. In this paper, we examine the nature of futility and question whether it is a sufficiently robust concept to meet the ethical and clinical demands placed upon it. Although the concept of futility promises simplicity, it cannot stand alone as a satisfactory framework for clinical decision-making. Practitioners and policy makers should be cautious about their use of the concept.
无效治疗的概念常常被用来为放弃治疗以及诸如“不要尝试复苏”（DNAR）等决定提供正当理由。在此方面，无效治疗在多套官方临床指南的制定过程中发挥了重要作用。在本文中，我们探讨了无效治疗的本质，并质疑它是否是一个足够有力的概念，以满足施加于它的伦理和临床要求。尽管无效治疗的概念看似简单，但它不能单独作为一个令人满意的临床决策框架。从业者和政策制定者在使用这一概念时应谨慎行事。
