End-of-life care decisions: importance of reviewing systems and limitations after 2 recent North American cases

Mayo Clin Proc. 2012 Nov;87(11):1098-105. doi: 10.1016/j.mayocp.2012.04.019.


Two recent and unfortunate North American cases involving end-of-life treatment highlight the difficulties surrounding medical futility conflicts. As countries have explored the greater influence that patients and their representatives may play on end-of-life treatment decisions, the benefits and struggles involved with such a movement must be appreciated. These 2 cases are used to examine the present systems existing in the United States and Canada for resolving end-of-life decisions, including the difficulty in defining medical futility, the role of medical ethics committees, and controversies involving surrogate decision making.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Attitude to Death
  • Canada
  • Caregivers / ethics*
  • Caregivers / psychology
  • Child, Preschool
  • Critical Illness / nursing
  • Decision Making
  • Ethics, Medical*
  • Humans
  • Intensive Care Units / ethics
  • Male
  • Medical Futility / ethics*
  • Terminal Care / ethics*
  • Third-Party Consent / ethics*
  • United States