Research report a preliminary analysis of medical futility decisionmaking:Law and professional attitudes

Judicial decisions reviewed in this article indicate that courts have taken two disparate approaches to disputes over futility of treatment. To explor e whether a consensus on medical futility is developing among hospitals, th e authors conducted a nationwide survey of health care professionals at hos pitals. Respondents assigned importance ratings to factors used in recent f utility decisions made at their institutions. The resulting importance rati ngs showed significant variation by characteristics of the institution (com paring respondents from for-profit, not-for-profit, and government hospital s) and by profession of the respondent (comparing physicians and nurses). T he respondents' judgments endorsed three distinct strategies for making fut ility decisions (i.e., emphasis on the patient's decision preferences, prov iding for the patient and family, and adhering to objective medical and soc ial norms). (C) 1998 John Wiley & Sons, Ltd.