A preventive ethics approach to counseling patients about clinical futility in the primary care setting
D. J. Doukas and L. B. McCullough
Department of Family Practice, University of Michigan, Ann Arbor, USA.
Given the current themes of futility and managed care in medicine and
bioethics, the primary care setting needs to account for how to address
futility. We argue for applying the concept of clinical futility to primary
care medicine. A preventive ethics approach directs the primary care
physician to explain and counsel against futile interventions, with a
negotiation strategy for circumstances of disagreement. These efforts will
require primary care physicians to concentrate their efforts on education,
negotiation, and enhanced trust in their patient relationships. Using a
preventive ethics approach in these circumstances, the physician can better
protect the interests of the patient by avoiding nonbeneficial
interventions, especially those that also are potentially harmful.
