Pediatric Futility Controversies: Ethical and Legal Considerations

In May 2011, at the Pediatric Academic Societies meeting in Denver:  “Futility Controversies: Ethical and Legal Considerations”  Here is the program description:

In pediatric clinical ethics today, the most common and intractable controversy is about medically futile therapy. Doctors and nurses get frustrated when they believe that further medical treatment is futile, but family members insist that treatment be continued. For professionals, such demands create a clash between their own personal moral beliefs and perceived legal or institutional constraints that force them to act in ways that violate those beliefs. Bioethicists are divided about the appropriate response to such dilemmas. Many professional societies, some hospitals, and some states have policies or laws to deal with these controversies. In this session, we will discuss the legal and philosophic basis for the conflict, review laws, legal cases, and statutes that are designed to address the issues, and will suggest ways that clinicians can respond to futility conflicts. Dr. Truog, an Anesthesiologist, Intensivist, and Bioethicist, will discuss the ways in which futile care might be symbolically important to family members. Dr. Feudtner, a general pediatrician, pallliative care physician, and bioethicist will discuss the ways in which discussions with families about hope can help redirect the goals of care from life-prolongation toward the circumstances of dying. Dr. Meadow, a neonatologist and bioethicist, will present cases from the NICU in which futility controversies were successfully resolved. He will present conversational strategies to help clinicians reach agreements with parents about appropriate care.

1:00 PM -	Background of the Futility Controversy John  D. Lantos Professor of Pediatrics, University of Missouri - Kansas City, Director, Children's Mercy Bioethics Center, Children's Mercy Hospital, Kansas City, MO
1:10 PM -	Why It is Sometimes Appropriate to Provide Futile Care Robert  D. Truog Childrens Hospital Boston, Boston, MA
1:40 PM -	Discussions with Families About Hope Can Help Redirect the Goals of Care from Life-prolongation Toward the Circumstances of Dying Chris   Feudtner The Children's Hospital of Philadelphia, Philadephia, PA
2:10 PM -	Conversational Strategies to Help Clinicians Reach Agreements with Parents about Appropriate Care William  L. Meadow University of Chicago, Chicago, IL
2:40 PM -	Discussion Discussion