Lisa Day’s timely article, “Medical Futility, Personal Goods, and Social Responsibility,”1 touched on the importance of discussing the concept of futility in talks with patients and families at the end of life. I strongly agree that defining futility in the face of situations where patients and families “want everything done as long as there is hope” is incredibly difficult. Yet it remains the responsibility of those of us who provide care to individuals and their families to guide them to realistic decisions when most would agree that treatment is futile.

Now that we see the cost of health care skyrocketing and face health care reform, we can’t ignore the social responsibility aspect of this article. We simply can’t ignore the fact that resources are limited. As health care providers pay more attention to the importance of developing skilled communication in end-of-life discussions,...

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