Abstract
BackgroundThe current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility.MethodsTo examine the attitudes of the Japanese experts in the fields relevant to medical futility a questionnaire survey was conducted among the members of the Japan Association for Bioethics. A total number of 108 questionnaires returned filled in, giving a response rate of 50.9%. Among the respondents 62% were healthcare professionals (HCPs) and 37% were non-healthcare professionals (Non-HCPs).ResultsThe majority of respondents (67.6 %) believed that a physician's refusal to provide or continue a treatment on the ground of futility judgment could never be morally justified but 22.2% approved such refusal with conditions. In the case of physiologically futile care, three-quarters believed that a physician should inform the patient/family of his futility judgment and it would be the patient who could decide what should be done next, based on his/her value judgment. However more than 10% said that a physician should ask about a patient's value and goals, but the final decision was left to the doctor not the patient. There was no statistically significant difference between HCPs and Non-HCPs (p = 0.676). Of respondents 67.6% believed that practical guidelines set up by the health authority would be helpful in futility judgment.ConclusionThe results show that there is no support for the physicians' unilateral decision- making on futile care. This survey highlights medical futility as an emerging issue in Japanese healthcare and emphasizes on the need for public discussion and policy development.
Highlights
The current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility
Attitudes towards medical futility in general The majority (67.6%) of respondents believed that physicians' refusal to offer or continue a treatment on the ground of futility judgment can never be morally justified but 22.2% approved such refusal with conditions
A higher proportion of healthcare professionals (73%) disagree with the morality of such refusal based on medical futility, compare to non-healthcare professionals (60%), the difference did not have statistical significance (p = 0.252, x2 = 1.315)
Summary
The current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility. The care of the elderly is going to be a major health problem in more developed regions of the world like Japan and Western countries. These concerns have led to a call for a re-approach to the matter of medical futility. The current debate about the issue of medical futility is mostly driven by theoretical and limited personal assumptions. There is a lack of empirical data to document experts and public attitudes towards medical futility
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