Rising Number of U.S. Futility Disputes

During dinner at the Brandeis-Princeton-RWJF conference a few weeks ago, the CMO at UCLA said that he sees a futility case every couple of weeks.  Extrapolating 100 cases per year from UCLA to the roughly 3500 U.S. hospitals that provide critical care medicine, one can very very roughly arrive at a nationwide annual figure of 350,000 cases per year.  Moreover, UCLA is, by most measures, a high-intensity hospital.  One might expect fewer futility disputes at such facilities because the aggressive care sought by surrogates is exactly the same care that the staff is happy to provide.  But as high-intensity hospitals are pushed to become lower-intensity hospitals, the rate of disputes is likely to rise.