Rituals, death and the moral practice of medical futility

Nurs Ethics. 2009 May;16(3):292-302. doi: 10.1177/0969733009102691.


Medical futility is often defined as providing inappropriate treatments that will not improve disease prognosis, alleviate physiological symptoms, or prolong survival. This understanding of medical futility is problematic because it rests on the final outcomes of procedures that are narrow and medically defined. In this article, Walker's ;expressivecollaborative' model of morality is used to examine how certain critical care interventions that are considered futile actually have broader social functions surrounding death and dying. By examining cardiopulmonary resuscitation and life-sustaining intensive care measures as moral practices, we show how so-called futile interventions offer ritualistic benefit to patients, families, and health care providers, helping to facilitate the process of dying. This work offers a new perspective on the ethical debate concerning medical futility and provides a means to explore how the social value of treatments may be as important in determining futility as medical scientific criteria.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel
  • Attitude to Death
  • Attitude to Health
  • Ceremonial Behavior*
  • Critical Care / ethics*
  • Critical Care / psychology
  • Decision Making / ethics*
  • Dissent and Disputes
  • Humans
  • Medical Futility / ethics*
  • Medical Futility / psychology
  • Morals
  • Nurse's Role / psychology
  • Philosophy, Medical
  • Philosophy, Nursing
  • Prognosis
  • Resuscitation / ethics
  • Resuscitation / psychology
  • Terminal Care / ethics*
  • Terminal Care / psychology
  • Withholding Treatment / ethics*