IS FUTILITY A FUTILE CONCEPT

This paper distinguishes four major types of futility (physiological, imminent demise, lethal condition, and qualitative) that have been adv ocated in the literature either in a patient dependent or a patient in dependent fashion. It proposes five criteria (precision, prospective, social acceptability, significant number, and non-agreement) that any definition of futility must satisfy if it is to serve as the basis for unilaterally limiting futile care. It then argues that none of the de finitions that have been advocated meet the criteria, primarily becaus e their proponents have not paid sufficient attention to the problemat ic nature of the data supporting the use of their definitions.