The Empirical Basis for Determinations of Medical Futility

In a soon-to-be-published article in the Journal of General Internal Medicine, nephrologist Ezra Gabbay and Tufts colleagues examine the empirical basis for determinations of medical futility.  Not surprisingly, after an extensive literature review to support Schneiderman's "1 in 100" threshold rule, they find that there is no such basis.  





There is both a lack of sufficient data and a lack of statistical confidence.  The authors conclude that "applying empirical outcome data to decisions about limiting treatment in critically ill patients is fraught with statistical and methodological problems."  The few studies that do provide data meeting Schneiderman's definition are limited to CPR.