Mediative fluency and futility disputes

Samantha F. Knowlton, Joseph Fins

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Futility disputes are more likely to be resolved—and relational breaches repaired—by engaging in a process that fosters communication between clinicians, patients, and families. This essay calls for mediative fluency. The preemptive use of a futility definition can stifle conversation when it is needed most, exacerbating the very power imbalances and associated health disparities that often precipitate futility disputes. When clinicians, patients, and families engage in dialogue, clinicians can appreciate what motivates requests for what is thought to be futile care, and patients and families can better understand the limits of available therapies. This sharing of knowledge, values, and attitudes cannot be achieved through the unilateral invocation of a futility definition. Furthermore, futility definitions are prone to interpretative judgment by clinicians and can be informed by the norms and attitudes attendant to a practitioner’s medical specialty. They also need to be interpreted in the context of emerging trends in medical therapeutics and in relation to the clinical details of each case. In the aggregate, these challenges make the application of a futility definition futile.

Original languageEnglish (US)
Pages (from-to)373-382
Number of pages10
JournalPerspectives in Biology and Medicine
Volume60
Issue number3
DOIs
StatePublished - Jun 1 2018

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health Policy
  • History and Philosophy of Science

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