Abstract
IntroductionSurgeons frequently deliver “bad news” to patients, but do they know how to address situations where further surgery is considered futile? Is there a clear definition of futile care in the literature? This paper explores these questions and seeks to start a conversation about how we can train future surgeons to deliver news of futile care. Presentation of caseThis paper describes how one surgical team handled a difficult case of futile care and provides an interview from the perspective of a surgical resident. DiscussionThe case report gives one example of how the news of futile care was delivered and how appropriate steps were taken to provide continued management of the patient and support to the family. A systematic review of the literature surrounding futile care reveals no consensus on how to define futile care within the medical community. ConclusionThere is a paucity of information surrounding how surgeons should manage cases of futile care. The literature focuses on the physician-patient relationship and includes methods for delivering bad news, yet it fails to identify a consensus definition of futile care and does not provide guidelines that future surgeons can follow when they encounter these cases. With this paper we seek to open a discussion about how to define futile care and how to teach future surgeons best practices when managing these cases.
Highlights
Surgeons frequently deliver “bad news” to patients, but do they know how to address situations where further surgery is considered futile? Is there a clear definition of futile care in the literature? This paper explores these questions and seeks to start a conversation about how we can train future surgeons to deliver news of futile care
This paper aims to address the scarcity of information about futile care, highlight an example of a case involving futile care, and provide a starting point for a conversation into how we can train surgeons to suitably deal with these types of cases
According to our review of the literature, we present the first known surgical case report to serve as an example of how a surgical team delivered news of futile care and established a comprehensive plan with the patient and family to provide continued management and support in a manner that was appropriate and conscientious of their needs
Summary
This paper explores these questions and seeks to start a conversation about how we can train future surgeons to deliver news of futile care. DISCUSSION: The case report gives one example of how the news of futile care was delivered and how appropriate steps were taken to provide continued management of the patient and support to the family. The literature focuses on the physician-patient relationship and includes methods for delivering bad news, yet it fails to identify a consensus definition of futile care and does not provide guidelines that future surgeons can follow when they encounter these cases. While the scientific literature has explored ways to deliver bad news [1], it has stopped short of clearly defining futile care and outlining best practices for management of these cases. The work presented here has been reported in line with the SCARE criteria
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