The concept of futility in health care decision making

Nurs Ethics. 2004 Jan;11(1):77-83. doi: 10.1191/0969733004ne668oa.


Life saving or life sustaining treatment may not be instigated in the clinical setting when such treatment is deemed to be futile and therefore not in the patient's best interests. The concept of futility, however, is related to many assumptions about quality and quantity of life, and may be relied upon in a manner that is ethically unjustifiable. It is argued that the concept of futility will remain of limited practical use in making decisions based on the best interests principle because it places such high demands on the individual responsible for decision making. This article provides a critical analysis of futility (in the context of the best interests decision-making principle), and proposes an ethically defensible notion of futility.

Publication types

  • Review

MeSH terms

  • Australia
  • Caregivers / ethics
  • Decision Making, Organizational*
  • Ethics, Nursing
  • Humans
  • Life Support Care / ethics*
  • Medical Futility / ethics*
  • Medical Futility / psychology
  • Practice Patterns, Physicians' / ethics
  • Resuscitation Orders / ethics