How to recognize when medical treatments are futile and how to respond as a conscientious and ethical physician has been discussed in the medical literature and in medical practice for many years. The problems that ensue when a patient or family demands what are considered by providers to be unreasonable treatments seem to come up more often as more technologies become available to sustain life and prolong dying. Despite the risk of redundancy (there is already a flood of literature addressing medical futility), in this column I will review some aspects of the medical futility debate and suggest that discussions of treatment futility ought to consider the benefits and burdens to the larger community and include public debate of the social responsibilities of providers and patients.

The California Medical Association advanced directive form includes the following 2 options for a patient to indicate...

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