Lelie Annique, Verweij Marcel
Health Care Ethics, Office for Research, Education and Advice, Wageningen, The Netherlands.
Bioethics. 2003 Feb;17(1):21-31. doi: 10.1111/1467-8519.00319.
The futility debate may be considered as an effort to provide a clear and justified borderline between physician and patient decision-making authority. In this paper we argue that the search for a definition of futility that provides physicians with a final argument in discussions about life-prolonging treatment, is misplaced. An acceptable and meaningful criterion of futility that satisfies this effort seems impossible. As a consequence, we reject a dichotomous domain of decision-making power as the starting point for definitions of futility. A good decision about withholding life-sustaining treatment should be justified from the perspectives of both physician and patient. In this light, a range of definitions of futility is still useful as it can clarify intuitions that a treatment is inappropriate.
关于医疗无效性的争论可以被视为一种努力，旨在为医生和患者的决策权力提供一个清晰且合理的界限。在本文中，我们认为，寻求一种能让医生在关于延长生命治疗的讨论中拥有最终论据的无效性定义，是找错了方向。满足这一努力的可接受且有意义的无效性标准似乎是不可能的。因此，我们拒绝将决策权力的二分领域作为无效性定义的出发点。关于停止维持生命治疗的一个好的决策，应该从医生和患者双方的角度都能说得通。鉴于此，一系列无效性定义仍然是有用的，因为它可以澄清一种治疗不合适的直觉。
