Summary: The absence of a useful purpose or useful result in a diagnostic procedure or therapeutic intervention. The situation of a patient whose condition will not be improved by treatment or instances in which treatment preserves permanent unconsciousness or cannot end dependence on intensive medical care. (From Ann Intern Med 1990 Jun 15;112(12):949)
Publications250 found, 100 shown here
- When do we stop, and how do we do it? Medical futility and withdrawal of careDaniel B Hinshaw
University of Michigan School of Medicine and VA Medical Center, 2215 Fuller Road, Ann Arbor, MI 48105, USA
J Am Coll Surg 196:621-51. 2003
- Unilateral withholding and withdrawal of potentially life-sustaining treatment: a violation of dignity under the law in CanadaJocelyn Downie
Health Law Institute, Faculty of Law, Dalhousie University, Halifax, Nova Scotia, Canada
J Palliat Care 20:143-9. 2004..I then offer a concrete proposal for institutional policy with respect to unilateral withholding and withdrawal of treatment in light of the law...
- "Futile" care: do we provide it? Why? A semistructured, Canada-wide survey of intensive care unit doctors and nursesValerie A Palda
Department of Medicine, University of Toronto, Toronto, ON, Canada
J Crit Care 20:207-13. 2005..To qualitatively explore the process of the provision of futile care in Canadian intensive care units (ICUs)...
- Best interests, public interest, and the power of the medical professionJohn Coggon
Centre for Social Ethics and Policy and Institute for Science, Ethics and Innovation, School of Law, University of Manchester, Oxford Road, Manchester M13 9PL, UK
Health Care Anal 16:219-32. 2008..Following an assessment of some of their principal concerns, it is suggested that best interests in fact provides a construct that is both defensible and desirable...
- Medical futility at the end of life: the perspectives of intensive care and palliative care cliniciansRalf J Jox
Institute of Ethics, History and Theory of Medicine, University of Munich, Lessingstrasse 2, 80336 Muenchen, Germany
J Med Ethics 38:540-5. 2012b>Medical futility at the end of life is a growing challenge to medicine...
- Forgoing life support in western European intensive care units: the results of an ethical questionnaireJ L Vincent
Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Belgium
Crit Care Med 27:1626-33. 1999..To determine current views of European intensive care physicians regarding end-of-life decisions...
- Futility approaches to interim monitoring by data monitoring committeesDavid L Demets
University of Wisconsin Madison, Department of Biostatistics and Medical Informatics, Madison, Wisconsin 53792 4675, USA
Clin Trials 3:522-9. 2006..These will be briefly summarized. However useful these methods might be, they alone are not adequate to make the decision and the DMC must take into account other issues to make a judgment...
- Tackling medical futility in TexasRobert D Truog
Department of Anesthesia at Harvard Medical School and the Division of Critical Care Medicine at Children s Hospital Boston, Boston, USA
N Engl J Med 357:1-3. 2007
- The development of "medical futility": towards a procedural approach based on the role of the medical professionS Moratti
Department of Legal Theory, Faculty of Law, University of Groningen, PO Box 716, 9700 AS Groningen, The Netherlands
J Med Ethics 35:369-72. 2009..Not everything that is technically possible is appropriate in a specific case: not everything that could be done should be done. In the 1980s, a new term was coined to indicate a class of inappropriate..
- Perceptions of "futile care" among caregivers in intensive care unitsRobert Sibbald
Department of Ethics, London Health Sciences Centre, London, Ont
CMAJ 177:1201-8. 2007..We sought to explore how ICU staff define medically futile care, why they provide it and what strategies might promote a more effective use of ICU resources...
- Does professional autonomy protect medical futility judgments?Eric Gampel
Department of Philosophy, California State University, Chico, CA 94929, USA
Bioethics 20:92-104. 2006..quite common, and has been backed by the implementation of hospital policies and professional guidelines on medical futility. The controversy arises when health care professionals (HCPs) consider a treatment futile which patients or ..
- Fruitful or futile: intensive care nurses' experiences and perceptions of medical futilityMelodie Heland
Intensive Care Unit, Austin Hospital, Melbourne VIC
Aust Crit Care 19:25-31. 2006..the perceptions and experiences of nurses practising in adult intensive care units (ICUs) with regard to medical futility. A qualitative exploratory descriptive design was used, providing a framework which enabled information to be ..
- Medical futility in children's nursing: making end-of-life decisionsIrene O Brien
Our Lady s Hospital for Sick Children, Crumlin, Dublin
Br J Nurs 19:352-6. 2010..The concept of medical futility must be considered under these circumstances...
- Medical futility: definition, determination, and disputes in critical careJames L Bernat
Dartmouth Medical School, Hanover, NH, USA
Neurocrit Care 2:198-205. 2005Physicians may employ the concept of medical futility to justify a decision not to pursue certain treatments that may be requested or demanded by patients or surrogates...
- Futility: a concept in evolutionJeffrey P Burns
Division of Critical Care Medicine, Department of Anesthesia, Children s Hospital Boston and Harvard Medical School, Boston, MA 02115, USA
Chest 132:1987-93. 2007....
- Identifying potentially ineffective care in the sickest critically ill patients on the third ICU dayBekele Afessa
Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA
Chest 126:1905-9. 2004..To determine if an increase in the third-ICU-day acute physiology score (APS) of the APACHE (acute physiology and chronic health evaluation) III prognostic system can identify potentially ineffective care...
- Medical futility: predicting outcome of intensive care unit patients by nurses and doctors--a prospective comparative studySonia Frick
Medical ICU, University Hospital, Geneva, Switzerland
Crit Care Med 31:456-61. 2003....
- Medical futility in asystolic out-of-hospital cardiac arrestT Vayrynen
Helsinki Emergency Medical Services EMS, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland
Acta Anaesthesiol Scand 52:81-7. 2008To study the factors associated with short- and long-term survival after asystolic out-of-hospital cardiac arrest, with a reference to medical futility.
- Moral justifications for surrogate decision making in the intensive care unit: implications and limitationsRobert M Arnold
Department of Medicine, University of Pittsburgh Cancer Institute, PA 15213, USA
Crit Care Med 31:S347-53. 2003..We end by offering a number of specific suggestions for improving communication with surrogates...
- Beyond futility: to what extent is the concept of futility useful in clinical decision-making about CPR?Suzanne Kite
Palliative Medicine at the Leeds General Infirmary and Cookridge Hospitals, Yorkshire, Leeds, UK
Lancet Oncol 3:638-42. 2002..Although the concept of futility promises simplicity, it cannot stand alone as a satisfactory framework for clinical decision-making. Practitioners and policy makers should be cautious about their use of the concept...
- Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trialLawrence J Schneiderman
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093, USA
JAMA 290:1166-72. 2003..Ethics consultations increasingly are being used to resolve conflicts about life-sustaining interventions, but few studies have reported their outcomes...
- What medical futility means to cliniciansMark R Tonelli
University of Washington, Box 356522, 1959 NE Pacific St, Seattle, WA 98195 6522, USA
HEC Forum 19:83-93. 2007
- Do-not-resuscitate orders and medical futilityMichael D Cantor
National Center for Ethics in Health Care of the Veterans Health Administration, Washington, DC 20420, USA
Arch Intern Med 163:2689-94. 2003..It also reviews current controversies surrounding the subject of do-not-resuscitate (DNR) orders and medical futility, discusses the complex medical, legal, and ethical considerations involved, and then offers recommendations ..
- Current controversies in data monitoring for clinical trialsStuart J Pocock
Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK
Clin Trials 3:513-21. 2006..The examples serve to illustrate that the practicalities of DMC decision-making require wise judgements based on a totality of evidence, making any statistical boundary just an objective guideline rather than a definitive stopping rule...
- End-of-life care: what do the American courts say?J M Luce
Department of Medicine and Anesthesia, University of California, San Francisco, CA, USA
Crit Care Med 29:N40-5. 2001..By using the principle of double effect, these guidelines allow physicians to give sedative and analgesic agents to dying patients if they intend to relieve pain and suffering but not to hasten death...
- A simple algorithm for designing group sequential clinical trialsD A Schoenfeld
Massachusetts General Hospital Biostatistics, Boston 02114, USA
Biometrics 57:972-4. 2001..This article describes a simple algorithm for calculating probabilities associated with group sequential trials. This allows the choice of boundaries that may not be among those implemented in available software...
- Conflict resolution at the end of lifeM D Fetters
Department of Family Medicine and Japanese Family Health Program, University of Michigan Health System, Ann Arbor, MI 48109 0708, USA
Crit Care Med 29:921-5. 2001..This study sought to investigate physicians' strategies for resolving conflicts with dying patients...
- Futile care and the neonateTricia L Romesberg
Department of Pediatrics, Neonatology Division, University of New Mexico Children s Hospital, Albuquerque, NM 87131, USA
Adv Neonatal Care 3:213-9. 2003..An increased focus on neonatal palliative care is suggested to provide infants, families, and staff with the necessary tools to work through this painful process...
- Futility-of-care decisions in the treatment of moribund intensive care patients in a developing countrySeetharaman Hariharan
Department of Anaesthesia, Surgery and Surgical Intensive Care, Queen Elizabeth Hospital, Barbados, West Indies
Can J Anaesth 50:847-52. 2003..To analyze the characteristics of moribund patients in a surgical intensive care unit (ICU) and highlight the dilemmas inherent in treating such patients...
- Avoiding the futility of resuscitationK Khalafi
Department of Medicine, Huron Hospital, 13951 Terrace Road, Cleveland, OH 44112, USA
Resuscitation 50:161-6. 2001..To identify patients who should not have resuscitation started or continued...
- The Schiavo and Korp cases: conceptualising end-of-life decision-makingLoane Skene
Faculty of Law, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Vic, Australia
J Law Med 13:223-9. 2005..That deflects attention from the fundamental legal principle that whatever a patient or the relatives want, they are not legally entitled to demand treatment that doctors consider futile in the circumstances...
- Withholding treatment, withdrawing treatment, and palliative care in the neonatal intensive care unitFrans J Walther
Neonatal Center, Department of Pediatrics, Leiden University Medical Center, J6 S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
Early Hum Dev 81:965-72. 2005..Perinatal audit and after-care of the family complete the process. The Dutch viewpoint and practice guidelines on withholding and withdrawing of neonatal intensive care are presented...
- Limiting and rationing treatment in paediatric and neonatal intensive carePeter Marc Fortune
Royal Manchester Children s Hospital, Pendlebury, Manchester M20 3FJ, UK
Best Pract Res Clin Anaesthesiol 20:577-88. 2006..I have drawn the discussions closer to clinical practice with the intention of making them more useful, for those engaged in direct patient care, than those focused around philosophical principles...
- Conjoined twins: the conflict between parents and the courts over the medical treatment of childrenHeather Tierney
University of Denver, Graduate School of International Studies, USA
Denver J Int Law Policy 30:458-75. 2002
- Artificial nutrition and hydration at the end of life: whose decision is it?Barbara A Biedrzycki
School of Medicine, Johns Hopkins University, Baltimore, MD, USA
ONS News 20:8, 10. 2005
- Ethical postures of futility and California's Uniform Health Care Decisions ActMatthew S Ferguson
University of Southern California, USA
South Calif Law Rev 75:1217-56. 2002
- Characteristics of end-of-life decisions: survey of UK medical practitionersClive Seale
School of Social Science and Law, Brunel University, Middlesex, UK
Palliat Med 20:653-9. 2006..To assess the extent to which UK doctors discuss end-of-life decisions (ELDs) with patients, relatives and colleagues, and to assess the degree to which patients' lives are shortened by ELDs...
- Withdrawing treatment for the "wrong" reasonsSteven J Baumrucker
Wellmont Holston Valley Palliative Medicine Service and Eastern Tennessee State University College of Medicine, Johnson City, Tennessee, USA
Am J Hosp Palliat Care 24:509-14. 2007
- New York's Do-Not-Resuscitate law: groundbreaking protection of patient autonomy or a physician's right to make medical futility determinations?Edward F McArdle
Office of the New York Attorney General, USA
DePaul J Health Care Law 6:55-82. 2002
- Nurse views of the adequacy of decision making and nurse distress regarding artificial hydration for terminally ill cancer patients: a nationwide surveyMitsunori Miyashita
Department of Adult Nursing Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7 3 1 Hongo Bunkyo ku, Tokyo, Japan
Am J Hosp Palliat Care 24:463-9. 2007..Medical practitioners caring for terminally ill cancer patients should engage in greater discussion among patient-centered teams and facilitate individualized decision making...
- Culture as a useful conceptual tool in clinical ethics consultationHenry S Perkins
Ecumenical Center for Religion and Health, and the University of Texas Health Science Center, San Antonio, USA
Camb Q Healthc Ethics 17:164-72. 2008
- End-of-life challenges: honoring autonomySharon M Valente
Department of Veterans Affairs and the University of Southern California, Los Angeles, CA, USA
Cancer Nurs 27:314-9. 2004..JAMA. 2000;284:2907-2911). Ethical issues and guidelines for management of patients and evaluation of rationality are presented...
- Whose interests are they, anyway?Margaret E Mohrmann
J Relig Ethics 34:141-50. 2006..There remains much to be done in defining and discerning basic interests and in distinguishing whose interests are on the table when decisions are being made for seriously ill and dying children...
- Implementing a resuscitation policy for patients at the end of life in an acute hospital setting: qualitative studyFrances Robinson
Palliative Medicine, Sperrin Lakeland Trust, Tyrone County Hospital, Omagh, Co Tyrone, Northern Ireland
Palliat Med 21:305-12. 2007..To explore attitudes and experiences of doctors and nurses regarding cardiopulmonary resuscitation for patients with end stage illness in an acute hospital...
- Erring on the side of Theresa Schiavo: reflections of the special guardian ad litemJay Wolfson
University of South Florida Health Sciences Center, Tampa, USA
Hastings Cent Rep 35:16-9. 2005
- Clinical tales in neurology: a vegetative existenceK Rajasekharan Nair
Cosmopolitan Hospitals and Kerala Institute of Medical Sciences, Trivandrum 695011, India
Issues Med Ethics 10:55-7. 2002
- [End-of-life dilemmas]Vicente Valentín Maganto
Servicio de Oncologia Medica, Hospital Universitario 12 de Octubre, Madrid, Spain
Clin Transl Oncol 7:285-94. 2005..This article reviews the common symptoms in the final phase of life and describes the methods to manage the symptoms while supporting the patient and family through this difficult period...
- Managing conflict at the end of lifeM Gregg Bloche
Georgetown University, Washington, DC, USA
N Engl J Med 352:2371-3. 2005
- New and lingering controversies in pediatric end-of-life careMildred Z Solomon
Center for Applied Ethics and Professional Practice, Education Development Center, Newton, MA 02458, USA
Pediatrics 116:872-83. 2005....
- The baby MB case: medical decision making in the context of uncertain infant sufferingMonique Jonas
Centre for Professional Ethics, Keele Hall, Keele University, Staffordshire ST5 5BG, UK
J Med Ethics 33:541-4. 2007..It is suggested that when genuine uncertainty over the interests of an infant exists, parental views about treatment should prevail...
- The best interests test at the end of life on PICU: a plea for a family centred approachD Inwald
Paediatric Intensive Care Unit, 7th Floor, QEQM Building, St Mary s Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK
Arch Dis Child 93:248-50. 2008..These criticisms could be largely addressed by taking into account the interests of others, particularly the interests of close family members...
- Ethical issues in surgical palliative care: am I killing the patient by "letting him go"?Timothy M Pawlik
Department of Surgical Oncology, The University of Texas M D Anderson Cancer Center, Unit 444, P O Box 301402, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Surg Clin North Am 85:273-86, vii. 2005..An ethics of death and dying requires that the intent and the action of the moral agent be considered...
- "Inappropriate" treatment near the end of life: conflict between religious convictions and clinical judgmentAllan S Brett
Department of Medicine, Center for Bioethics and Medical Humanities, University of South Carolina, Columbia, SC 29203, USA
Arch Intern Med 163:1645-9. 2003....
- When is medical treatment futile? A guide for students, residents, and physiciansDeborah L Kasman
Department of Internal Medicine, Center for Bioethics, Washington, DC, USA
J Gen Intern Med 19:1053-6. 2004..This paper elucidates the concept of "medical futility," demonstrates the application of futility to practical patient care decisions, and suggests means for ..
- Medical futility in the neonatal intensive care unit: hope for a resolutionRobert L Fine
Office of Clinical Ethics, Baylor Health Care System, Dallas, Texas, USA
Pediatrics 116:1219-22. 2005..The process established under Texas law sets conceptual and temporal boundaries around the problem of medical futility and provides a legal safe harbor for physicians who seek to withdraw life-sustaining treatments in the ..
- The devil's choice: re-thinking law, ethics, and symptom relief in palliative careRoger S Magnusson
Faculty of Law, University of Sydney
J Law Med Ethics 34:559-69, 481. 2006..Using the devil's choice, the paper criticizes the principle of double effect and provides a re-interpretation of the conventional legal and ethical account of symptom relief in palliative care...
- Withholding hydration and nutrition in newbornsNicolas Porta
Division of Neonatology, Children s Memorial Hospital, Chicago, IL, USA
Theor Med Bioeth 28:443-51. 2007..Decisions to stop any form of life support should focus on the clinical circumstances, not the means used to sustain life...
- The benefits of a North Carolina policy for determining inappropriate or futile medical careArthur E Kopelman
Brody School of Medicine at East Carolina University, USA
N C Med J 66:392-4. 2005
- "Do everything!" Encountering "futility" in medical practiceStephen N Nelson
MeritCare Medical Group, Fargo, North Dakota, USA
Ethics Med 19:103-13. 2003
- Ethics consultation in dual diagnosis of mental illness and mental retardation: medical decisionmaking for community-dwelling personsKathryn E Artnak
Department of Nursing at Angelo State University, San Angelo, Texas, USA
Camb Q Healthc Ethics 17:239-46. 2008
- [Implementation of the French law related to the patients' rights and the end of life]A Lienhart
Ann Fr Anesth Reanim 25:491-2. 2006
- Living and dying in a post-Schiavo worldThomas Wm Mayo
Dedman School of Law, Southern Methodist University, USA
J Health Law 38:587-608. 2005..surrogate decisionmaker, attitudes towards artificial nutrition and dehydration, and difficulties in defining medical futility. Looking through a post-Schiavo lens, the Article examines state law addressing these issues and how these ..
- On medical futility: considerations and guidelinesMichael C Brannigan
Clinical and Organizational Ethics, Center for Practical Bioethics, Kansas City, MO, USA
Mo Med 103:113-7. 2006
- Withdrawing life support and resolution of conflict with familiesJenny Way
Department of Medicine, University of Washington, Seattle, WA 98195, USA
BMJ 325:1342-5. 2002
- Ethical and legal issues in end-of-life care: content of the End-of-Life Nursing Education Consortium curriculum and teaching strategiesMarianne LaPorte Matzo
Graduate School of Nursing, University of Massachusetts Worcester, Worcester, Massachusetts, USA
J Nurses Staff Dev 20:59-66; quiz 67-8. 2004..Competent end-of-life nursing care begins with an understanding of ethics and the potential affect on care of dying patients and their families...
- When parents request seemingly futile treatment for their childrenJohn Lantos
Department of Pediatrics, University of Chicago General, MacLean Center for Clinical Medical Ethics, IL 60637, USA
Mt Sinai J Med 73:587-9. 2006This paper reviews the development of the concept of medical futility, particularly as it applies to pediatrics...
- Experts' attitudes towards medical futility: an empirical survey from JapanAlireza Bagheri
Graduate School of Law, Kyoto University, Yoshida, Sakyo ku, 606 8501 Kyoto, Japan
BMC Med Ethics 7:E8. 2006BACKGROUND 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.
- Ethical issues in neonatal intensive care and physicians' practices: a European perspectiveMarina Cuttini
Unit of Epidemiology, Ospedale Pediatrico Bambino Gesu, Scientific Institute IRCCS, Rome, Italy
Acta Paediatr Suppl 95:42-6. 2006....
- Consultation of parents in actual end-of-life decision-making in neonates and infantsVeerle Provoost
End of Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
Eur J Pediatr 165:859-66. 2006..1%). Parents of infants with a small gestational age more often explicitly requested an ELD...
- Perceptions of patients on the utility or futility of end-of-life treatmentK L Rodriguez
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System 151C U, University Drive C, Bldg 28, MB 1A129, Pittsburgh, PA 15240 1000, USA
J Med Ethics 32:444-9. 2006Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few...
- Dialysis: prolonging life or prolonging dying? Ethical, legal and professional considerations for end of life decision makingY White
Department of Nursing, University of Wollongong, New South Wales, Australia
EDTNA ERCA J 32:99-103. 2006..Support for the patient and family during the dying period should be multi-disciplinary, with clear and timely communication between all members of the team...
- Legal and policy lessons from the Schiavo case: is our right to choose the medical care we want seriously at risk?Zita Lazzarini
Division of Medical Humanities, Health Law and Ethics, University of Connecticut School of Medicine, 263 Farmington Avenue, MC 6325, Farmington, CT 06030 6325, USA
Palliat Support Care 4:145-53. 2006..Issues of physician assistance in dying and medical futility are considered...
- Ethical aspects of withdrawing and withholding treatmentPaul Wainwright
Kingston University, Kingston upon Thames, Surrey
Nurs Stand 21:46-50. 2007..Further ethical issues discussed relate to judgements about the futility of treatment, patient autonomy and nurses' duty of care to patients at the end of life...
- Prehospital withholding and withdrawal of life-sustaining treatments. The French LATASAMU surveyEdouard Ferrand
Hopital Henri Mondor, Service d Anesthésie Réanimation SAMU SMUR 94, AP HP, 51, avenue du Mal de Lattre de Tassigny, 94010 Creteil Cedex, France
Intensive Care Med 32:1498-505. 2006..To investigate the end-of-life decision process in patients managed by emergency physicians in the prehospital setting...
- [Limiting life sustaining therapies]E Azoulay
Service de Reanimation Medicale, Hôpital Saint Louis et Université Paris 7, France
Rev Mal Respir 23:13S29-45. 2006..Intensivists are increasingly implementing end-of-life decisions in patients who remain dependent on life sustaining therapies without hope for recovery...
- National ethical directives and practical aspects of forgoing life-sustaining treatment in newborn infants in a Swiss intensive care unitMichel E Berner
Department of Paediatrics, Service of Neonatology and Paediatric Intensive Care, University Hospital, Geneva, Switzerland
Swiss Med Wkly 136:597-602. 2006..How do actual aspects of forgoing life supporting therapy (LST) in newborn infants compare with national ethical directives in a Swiss intensive care unit?..
- Withdrawing may be preferable to withholdingJean Louis Vincent
Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium
Crit Care 9:226-9. 2005..In this article, I will provide arguments why, although the two actions are indeed ethically equivalent, withdrawing life-sustaining therapy may in fact be preferable to withholding...
- Our cultures, our selves: toward an honest dialogue on race and end-of-life decisionsMark G Kuczewski
Loyola University Chicago Stritch School of Medicine, USA
Am J Bioeth 6:13-7; discussion W30-2. 2006
- End of life in ICU--care of the dying or 'pulling the plug'?N Collins
Dept of Intensive Care Medicine, Mater Hospital, Eccles St, Dublin
Ir Med J 99:112-4. 2006..Artificial nutrition and hydration were rarely withdrawn...
- [Withholding and withdrawing treatment, ethical and legal aspects]Reidar Pedersen
Seksjon for medisinsk etikk, Universitetet i Oslo, Postboks 1130 Blindern, 0318 Oslo
Tidsskr Nor Laegeforen 127:1648-50. 2007..In the wake of medical progress an important ethical discussion has arisen about when to withhold and when to withdraw life-sustaining treatment...
- When medical treatment is no longer in order: toward a new interpretation of the ordinary-extraordinary distinctionJos V M Welie
Center for Health Policy and Ethics, Creighton University Medical Center, Omaha, NE, USA
Natl Cathol Bioeth Q 5:517-36. 2005
- Relationship of neonatologists' end-of-life decisions to their personal fear of deathPeter Barr
Department of Neonatology, The Children s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia
Arch Dis Child Fetal Neonatal Ed 92:F104-7. 2007....
- Nurses' and physicians' opinions on aggressiveness of treatment for general ward patientsMia Svantesson
Centre for Nursing Science, Orebro University Hospital, Sweden
Nurs Ethics 13:147-62. 2006..When considering full treatment, nurses used quality-of-life rationales for significantly more patients than the physicians. Respect for patients' wishes had a minor influence...
- Futility without a dichotomy: towards an ideal physician-patient relationshipAnnique Lelie
Health Care Ethics, Office for Research, Education and Advice, Wageningen, The Netherlands
Bioethics 17:21-31. 2003..In this light, a range of definitions of futility is still useful as it can clarify intuitions that a treatment is inappropriate...
- The ground of dialogical bioethicsAbraham Rudnick
Department of Behavioral Sciences, Tel Aviv University School of Medicine, Tel Aviv 69978, Israel
Health Care Anal 10:391-402. 2002..The approach of dialogical bioethics has proven fruitful for resolving bioethical problems such as that of medical futility, where approaches of substantive ethics have reached an impasse...
- Well-child visits in the video age: pediatricians and the American Academy of Pediatrics' guidelines for children's media useDouglas A Gentile
Department of Psychology, Iowa State University, W112 Lagomarcino Hall, Ames, IA 50011 3180, USA
Pediatrics 114:1235-41. 2004..Pediatricians were also asked about how often they make media recommendations as part of anticipatory guidance during well-child visits, as well as the perceived efficacy of and barriers to making such recommendations...
- A novel, efficient, randomized selection trial comparing combinations of drug therapy for ALSPaul H Gordon
Department of Neurology, Columbia University, New York, USA
Amyotroph Lateral Scler 9:212-22. 2008..This phase II design was efficient, leading to treatment selection after just 60 patients, and can be used in other phase II trials to assess different agents...
- The ethics of measuring and modulating consciousness: the imperative of minding timeJoseph J Fins
Division of Medical Ethics, Weill Medical College of Cornell University, New York, NY, USA
Prog Brain Res 177:371-82. 2009..These cases often referred to as "late emergences" point to the importance of better understanding the natural history of these conditions and the tempo of associated recoveries...
- A randomized, placebo-controlled, double-blind clinical trial of curcuminoids in oral lichen planusN Chainani-Wu
Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA 94143 0658, USA
Phytomedicine 14:437-46. 2007....
- Ethical considerations behind the limitation of cardiopulmonary resuscitation in Hungary--the role of education and trainingGabor Elo
Hungarian Resuscitation Council, Working Group on Ethics and Law, 1125 Kútvölgyi u, 4 Budapest, Hungary
Resuscitation 64:71-7. 2005..In Hungary no such comprehensive study has been conducted yet. The goal of this investigation was to recognise the ethical factors limiting resuscitation in Hungary...
- Lack of benefit of maintenance paclitaxel in first-line chemotherapy in metastatic breast cancerAlessandra Gennari
National Cancer Research Institute, Largo Rosanna Benzi, Genoa, Italy
J Clin Oncol 24:3912-8. 2006..This randomized study compared maintenance paclitaxel with control in metastatic breast cancer patients not experiencing progression after first-line anthracycline/paclitaxel combination chemotherapy...
- Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: a randomised controlled trialMaria J Wawer
Department of Population, Family and Reproductive Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA
Lancet 374:229-37. 2009..We assessed whether circumcision in HIV-infected men would reduce transmission of the virus to female sexual partners...
- Monitoring rare serious adverse events from a new treatment and testing for a difference from historical controlsMichael P Fay
Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, 6700B Rockledge Drive, Bethesda, MD 20892 7609, USA
Clin Trials 4:598-610. 2007..Controlled but small clinical trials have not detected any increase in the SAE using albendazole, and it is known to have added benefits; therefore, it is unethical to randomize patients to the old regimen...
- Early insulin therapy in very-low-birth-weight infantsKathryn Beardsall
University of Cambridge, Cambridge, United Kingdom
N Engl J Med 359:1873-84. 2008..This international randomized, controlled trial aimed to determine whether early insulin replacement reduced hyperglycemia and affected outcomes in such neonates...
- Placebo-controlled, double-blind trial of intravenous ribavirin for the treatment of hantavirus cardiopulmonary syndrome in North AmericaGregory J Mertz
Internal Medicine, University of New Mexico, Albuquerque, New Mexico 87131 0001, USA
Clin Infect Dis 39:1307-13. 2004..BACKGROUND. Ribavirin is active in vitro against hantaviruses, but the findings of an open trial of the use of intravenous ribavirin for the treatment of hantavirus cardiopulmonary syndrome (HCPS) were inconclusive...
- High-dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitisKeith D Lindor
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA
Hepatology 50:808-14. 2009..01) and 2.1 times greater for death, transplantation, or minimal listing criteria (P = 0.038). Serious adverse events were more common in the UDCA group than the placebo group (63% versus 37% [P < 0.01])...
- Enhancing residents' training in medical ethics: an exploratory study assessing attitudes of internal medicine residentsRitabelle Fernandes
Department of Geriatric Medicine, John A Burns School of Medicine, University of Hawai i, Honolulu, HI 96817, USA
Hawaii Med J 67:317-21. 2008..They were most likely to request an ethics consult for issues concerning medical futility and disagreement resolution...
- High-dose fenretinide in oral leukoplakiaWilliam N William
Department of Thoracic Head and Neck Medical Oncology, The University of Texas M D Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Cancer Prev Res (Phila) 2:22-6. 2009..This result is consistent with our clinical finding that high-dose fenretinide did not improve on the historical response rate of lower-dose fenretinide in our previous oral leukoplakia trial...
- Cold blood and clinical research during World War IW C Hanigan
Department of Neurosurgery, University of Illinois College of Medicine at Peoria, USA
Mil Med 161:392-400. 1996..Robertson's success at technical innovation during World War I associated with a large clinical population resulted in the development of the indications and procedures for modern transfusion therapy...
- Triaging for adult critical care in the event of overwhelming needNigel Eastman
St George s Clinical Ethics Committee, St George s University of London, London, SW17 0RE, UK
Intensive Care Med 36:1076-82. 2010..Predictions of the need for critical care within the H1N1 influenza pandemic suggested overwhelming need beyond potential resources, necessitating rationing of care via triaging...
- Surgical Indirect Revascularization For Symptomatic Intracranial Aterial StenosisNestor Gonzalez; Fiscal Year: 2013....
- Trial Of Late SURFactant (TOLSURF) to Prevent BPD-Data Coordinating CenterDennis M Black; Fiscal Year: 2013..This research has potential to decrease chronic infant lung disease and asthma, important areas of public health, reduce cost of care, and improve long-term outcome for premature infants. ..
- Trial of Late SURFactant (TOLSURF) to Prevent BPD - Clinical Coord CtrROBERTA ANDERSON BALLARD; Fiscal Year: 2013..This research has potential to decrease chronic infant lung disease and asthma, important areas of public health, reduce cost of care, and improve long-term outcome for premature infants. ..
- Phase II/III Study of Arimoclomol in the Treatment of SOD1 Positive Familial?.Merit E Cudkowicz; Fiscal Year: 2013....
- Phase II, randomized controlled trial of brain tissue oxygen monitoringNancy R Temkin; Fiscal Year: 2011....
- A Randomized Controlled Trial to Reduce Pneumonia in Nursing Home ResidentsVINCENT JAMES QUAGLIARELLO; Fiscal Year: 2013..This trial holds great promise in identifying a simple and effective intervention to reduce pneumonia in this vulnerable population of citizens. ..
- Limited Competition for Continuation of the NIH Exploratory Trials in PDOksana Suchowersky; Fiscal Year: 2013..Secondly, this is the largest data set of information collected on PD, and is available to all investigators in the consortium. It will provide extensive information on PD. ..
- Futility Study of Deferoxamine Mesylate in Intracerebral Hemorrhage (Hi-DEF)Magdy H Selim; Fiscal Year: 2013..ICH is a frequent cause of disability and death. A successful stuy demonstrating the efficacy of DFO would be of considerable public health significance. ..
- Effect of Intra-Articular Steroids on Structural Progression of Knee OA: An RCTTimothy E McAlindon; Fiscal Year: 2013..We will conduct an adaptive interim analysis after the first half of participants has completed the trial. This will allow the trial to be stopped early for either success or futility, or otherwise continue. ..
- A Phase II Trial of Rituximab In Myasthenia GravisRichard Nowak; Fiscal Year: 2013..Additionally, we plan on collecting specimens to conduct an ancillary exploratory biomarker study, funded by NIAID, focused on identifying how treatment modifies the immunopathology of MG. ..
- Alzheimer's Prevention InitiativePierre N Tariot; Fiscal Year: 2012..The API is intended to help establish the biological measurements and accelerated FDA approval pathway needed to rapidly evaluate promising prevention therapies and find ones that work as quickly as possible. ..
- PRAGMATIC CLUSTER RANDOMIZED TRIAL OF AN ASTHMA INTERVENTION FOR URBAN TEENSMei Lu; Fiscal Year: 2013..If no futility is observed, we will seek funing for a Phase III trial with more HMORN sites and a larger study population. ..
- Developing a preventive cure for cerebral palsySidhartha Tan; Fiscal Year: 2010..The proposed studies will thus provide the framework for the systematic development of much-needed therapies for CP and thus expedite the clinical application of these therapies, ..
- Alzheimer's Prevention Initiative APOE4 TrialPierre N Tariot; Fiscal Year: 2013..The project is intended to help find effective preclinical treatments for late-onset AD as soon as possible. ..
- NIH Exploratory Trials in Parkinson's Disease (NET-PD): Clinical SiteJay S Schneider; Fiscal Year: 2013..Thus the Resume and Summary of Discussion is the final word on what the reviewers actually considered critical at the meeting. ..
- UAB PD Neuroprotection Clinical Trial CenterDavid G Standaert; Fiscal Year: 2013..abstract_text> ..
- A preclinical assessment of monthly intramuscular GSK1265744, an InSTI, as PrEPMARTIN H MARKOWITZ; Fiscal Year: 2013....
- Continuation of NET-PD Trials at the University of Kansas Medical CenterRajesh Pahwa; Fiscal Year: 2013..The focus of the University of Kansas will be to complete all required study visits and assessments and to make sure that all remaining subjects (28) continue their participation in the study until its completion. ..
- Coenzyme Q10 in Huntingtons DiseaseMerit E Cudkowicz; Fiscal Year: 2013..Any compound that slows disease course will have immediate clinical importance, and a positive outcome of this study will enhance our understanding of the underlying biology of HD. ..
- Parkinson's Disease Clinical Trial: Statistical CenterBarbara C Tilley; Fiscal Year: 2013..Aim 6 Maintain an administrative structure that allows close collaboration with the CCC, the clinical centers, NINDS Scientific Program personnel, the DSMB, and the NIH Oversight Board. ..
- Phase 2 Study of L-Serine in HSN Type 1Florian S Eichler; Fiscal Year: 2012..If patients in the placebo arm fail, they will be switched to L-serine. There will be an interim analysis at 12 and 18 months to assess for efficacy and futility, and accordingly the study will be stopped or continued. ..
- Coordination and Statistics for Coenzyme Q10 in Huntington's DiseaseMichael P McDermott; Fiscal Year: 2013....
- HeartMap Dynamic Registry PilotGraham Nichol; Fiscal Year: 2012..886. If 80% of enrolled AEDs are known at six months, there will be sufficient precision to reject an attrition rate below 0.781. ..
- Creatine Safety, Tolerability, and Efficacy in Huntington's Disease: CREST-ESteven M Hersch; Fiscal Year: 2013..A companion application is also submitted to support study coordination, data management, and biostatistical support under the auspices of the HSG (Bernard Ravina, principal investigator). ..
- Clinical Center for Neuroprotection in Parkinson DiseaseRichard B Dewey; Fiscal Year: 2013..abstract_text> ..
- Comparison of Bayesian and Frequentist Methods in Cardiovascular Clinical TrialsALICE ROGOT PRESSMAN; Fiscal Year: 2010....
- Neuroprotection Exploratory Trials in Parkinson's Disease (NET-PD)TANYA SIMUNI SIMUNI; Fiscal Year: 2013..abstract_text> ..
- Neuroprotection Studies in PD: A Coordinating Center.KARL D KIEBURTZ; Fiscal Year: 2013..Successful completion of these aims will achieve the goal of the NET-PD program to establish an innovative, evidence-based process by which potential therapies are selected and tested for slowing of PD progression. ..
- Continuation of NET-PD Trials at the University of MichiganKelvin L Chou; Fiscal Year: 2013..We plan on continuing to cooperate with other NET-PD centers, including the Coordination and Statistical Centers towards the goal of completing the current trials (LS-1 and FS-ZONE). ..
- Parkinson Disease Neuroprotective Trial: Clinical CenterBrad A Racette; Fiscal Year: 2013..The Washington University School of Medicine site has extensive experience with clinical trials and management of PD, making this an ideal site for this exploratory PD trials network. ..
- Neuroprotection Exploratory Trials in PD (NET-PD)Franca Cambi; Fiscal Year: 2013..In addition, we have developed strategies that target the population at our site. These measures have been so far successful in retaining subjects past the 5 years of the trial. ..
- Parkinson's Neuroprotection Trial: Clinical Center in Shreveport (Continuation)Richard M Zweig; Fiscal Year: 2013..We have also enrolled 5 subjects in the FS-Zone (pioglitazone) futility study, all of whom continue in the study with no missed follow-up visits. ..
- University of Colorado Parkinson's Disease Clinical ResearchMaureen A Leehey; Fiscal Year: 2013..UCD has a number of strengths detailed in this application, including individualized expert care to subjects, which underlie our success and the reason our site is a strong and necessary asset to the NET-PD program. ..
- Exploratory study of different doses of endurance exercise in people with ParkinsMargaret L Schenkman; Fiscal Year: 2013..All 3 components are critical in planning the next study investigating exercise in PD. We also recognize the possibility the trial will be declared futile, which will force us to reconsider the therapeutic value of exercise for PD ..
- Parkinson's Disease Neuroprotection Clinical Trial CenterVanessa K Hinson; Fiscal Year: 2013..abstract_text> ..
- Parkinson's disease research trial: clinical centerKathleen M Shannon; Fiscal Year: 2013..During the remaining years o NET-PD support. Clinical Sites may be deactivated or placed in a follow-up mode with budget reduction, depending on performance and protection of human subjects. ..
- Parkinson's Disease Neuroprotection Clinical TrialMartha A Nance; Fiscal Year: 2013..Members of our research team are named authors on three NET-PD publications, with several other manuscripts in preparation. ..
- Parkinson's Disease Neuroprotection Clinical TrialChad Christine; Fiscal Year: 2013..The FS-ZONE trial is a randomized, double-blind placebo-controlled futility study evaluating pioglitazone for the prevention of Parkinson's disease progression. The subjects will be followed for 44 weeks. ..
- Neuroprotection in Parkinson Disease: Clinical CenterRodger Elble; Fiscal Year: 2013..We are also a site for the futility trial of pioglitazone (FS-ZONE). This application is a request for continued funding as a participating center. ..
- Phase IIB Study of TNK in Acute Stroke (TNK-S2B-STAT)John Thompson; Fiscal Year: 2009..3)For efficiency, the 200 patients included in the initial TNK/rt-PA comparison will be included in the phase III trial (overall n = 1908 patients) if it proceeds. ..
- ALIAS II/III Trial:Albumin Therapy in Ischemic StrokeMYRON GINSBERG; Fiscal Year: 2004..At a minimum clinical effect size of 10%, a total of approximately 410 patients is required for the futility trial, and -1,950 for the efficacy trial. The primary outcome measure is the modified Rankin score at 3 months. ..
- NIH Exploratory Trials - Parkinson's DiseaseJohn Fang; Fiscal Year: 2013..It is hoped that these trials will demonstrate pharmacologic benefits in both motor and non-motor features of PD, and additional knowledge will be gained about clinical trial development and PD in general. ..
- Limited Competition for Continuation of the NIH Exploratory Trials in Parkinson'sDavid K Simon; Fiscal Year: 2013..An additional futility study is underway (the FS-ZONE study) to examine the potential for pioglitazone as a disease modifying therapy in PD. ..
- TRAUMATIC GRIEF IN LATER-LIFE: CRITERIA, RISKS, OUTCOMESHolly Prigerson; Fiscal Year: 2001..g., treatment of attachment disturbances) intervention will be identified, as will the mental and physical health impairments associated with meeting diagnostic criteria for TG. ..
- DRUG USE IN RURAL KENTUCKY--A CONTEXTUAL ANALYSISRichard Clayton; Fiscal Year: 2003..Cohort will be followed for 4 years through 10th grade into 45 high schools. HLM and latent growth curve modeling techniques will be used to test the theoretical models driving the research. ..
- Parkinson's Disease Neuroprotection TrialJulie H Carter; Fiscal Year: 2013..abstract_text> ..
- An Intervention to Reduce Futile End of Life Care in Elderly Surgical PatientsAngela Shoher; Fiscal Year: 2009..For the society at large decreasing futile, end of life care can help reduce the increasing medical cost and emotional distress associated with end of life care in our aging population. ..
- PREDICTING AND IMPROVING OUTCOMES IN ACUTE RENAL FAILURERavindra Mehta; Fiscal Year: 2001..It is anticipated (by the applicants) that information gained from this study, being largely observational, will be used to rationally design intervention strategies in future years. ..
- Medical Futility and Treatment Effect in DNR OrdersElizabeth Trice; Fiscal Year: 2000..This interest, in what has been called medical futility in the bioethics literature, is the product of rising concern regarding issues of quality of life, patient ..
- CBT and Modafinil for Cocaine AddictionRobert Malcolm; Fiscal Year: 2009....
- Novel small animal PET scanner using 2.0 mm lead-walled straw detectorsJeffrey Lacy; Fiscal Year: 2007..Imaging performance using a rotating gantry will be evaluated through phantom testing. Lower cost combined with quantum improvement in quality will afford an exceptional new molecular imaging tool. [unreadable] [unreadable] [unreadable]..
- INFORMATION BASED DESIGN AND INTERIM MONITORING SOFTWARECyrus Mehta; Fiscal Year: 2000..Software to design and monitor such studies is scarce, while the economic and ethical benefits of stopping early, either for efficacy or futility, are enormous. ..
- Coordination and Statistics for CoQ10 in PD in Phase 3David Oakes; Fiscal Year: 2009..To prepare reports for this committee including unblinded data &to maintain &document the confidentiality of such reports. ..
- Dose and Treatment Selection in Clinical TrialsYing Kuen Cheung; Fiscal Year: 2010....
- SC Cooperative for Healthy Aging in Minority PopulationsBarbara Tilley; Fiscal Year: 2006....
- Balancing Hope & Truth-Telling for Patients with Ca/COPDJ Curtis; Fiscal Year: 2005..These strategies will be described and translated into interventions targeting nurses, physicians, and teams who provide care for patients with cancer, COPD, and other life-limiting diseases. ..
- Improving Physician Skill at Providing End-of-Life CareJ Curtis; Fiscal Year: 2004..The results will allow investigators and others to develop targeted educational and systemic interventions to improve the quality of this care. ..
- Type 1 Diabetes Trialnet: Operations Coord. CenterJohn Lachin; Fiscal Year: 2008..4) Documentation: We will provide for the orderly closeout of all studies with complete documentation and dissemination of relevant materials to the NIH and the public. ..
- ASTHMA AND INTERVENTIONS IN THE EMERGENCY DEPARTMENTRobert Strunk; Fiscal Year: 2002..The intent to treat model will be used, as primary outcome can be obtained after consent even if not contact cannot be made at 2 week and 6 month phone calls. ..
- Targeted Alpha-Particle Emitter Therapy of MetastasesGeorge Sgouros; Fiscal Year: 2009..The work described in this application is intended to develop and evaluate such an approach. ..
- Considerations of covariates in biomarker studiesMargaret S Pepe; Fiscal Year: 2010..Programs written in Stata will be made available through the Stata archive, the EDRN and through a 'Diagnostics and Biomarkers Statistical Center'web site. ..
- Reducing Barriers to Pain and Fatigue ManagementBetty Ferrell; Fiscal Year: 2009....
- Oncology Nursing Education in End of Life CareBetty Ferrell; Fiscal Year: 2007..This proposal includes extensive evaluation planned to monitor individual and institutional dissemination. [unreadable] [unreadable] [unreadable]..
- 5-Year Survival Following Injury in Geriatric PatientsLaura Criddle; Fiscal Year: 2006..Contribution: This foundational study will provide basic information about the survival patterns of injured elders as a basis for the development of interventions to improve geriatric survival. [unreadable] [unreadable] [unreadable]..
- End of Life Nursing Education through Graduate ProgramsBetty Ferrell; Fiscal Year: 2006..This proposal includes extensive evaluation planned to monitor individual and institutional dissemination. ..