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Medical Futility in Dutch Neonatology

By Technical Books Center

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Book Id: WPLBN0003761971
Format Type: PDF eBook :
File Size:
Reproduction Date: 2015

Title: Medical Futility in Dutch Neonatology  
Author: Technical Books Center
Language: English
Subject: Programming, Medical, Neonatology
Collections: Technical eBooks and Manuals Collection, Technical Books Center Collection
Publication Date:
Publisher: Technical Books Center


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Center, T. B. (1979). Medical Futility in Dutch Neonatology. Retrieved from

Description: This book is about the concept of ‘medical futility’ and the regulation and operationalisation of medical futility in Dutch Neonatal Intensive Care Units (NICUs). A NICU is a high-technology medical setting, where most of the life-prolonging treatment available for desperately sick newborns is administered. ‘Medical futility’ is a legal and ethical ground for withholding or withdrawing life-prolonging treatment from a patient whose condition is too poor to justify (further) medical intervention. It is supposed to be a ‘hard’ and ‘medical’ criterion, based on the doctor’s technical expertise. In connection with its (real or supposed) ‘objectivity’, ‘medical futility’ can be a ground for unilateral non-treatment decisions. This means that if a treatment is ‘medically futile’, the doctor or medical team should withhold or withdraw it even over the objections of a competent patient (or, in the case of a non-competent patient such as a baby, its representative). The interpretation of the concept of ‘futility’ necessarily allows a margin of flexibility. In the first place, the principle of proportionality must be taken into account.One of the basic principles ofmedicine is non-maleficience.1 Potentially life-prolonging treatment that will not cause harm to the patient is hardly subjected to ‘futility’ considerations. For example, some terminal patients choose to take part in clinical trials of treatment that is not yet part of routine medicine because there is not sufficient evidence of its benefit. Most of the experimental treatment administered in clinical trials does not cause adverse effects (or if it does, these are only minor). ‘Medical futility’ is more relevant where are significant chances that the treatment will cause a harm that is not proportional to the benefit. For example, this is the case of major surgery that is unlikely significantly to improve an incurable condition. A second qualification of the principle that futile treatment should not be given is that, whenever possible

Table of Contents
TOC : Introduction - The Concept Of ‘Medical Futility - The Regulation Of ‘Futility’ In Dutch Neonatology - Operationalisation Of ‘Futility’ In Two Dutch Nicus: Introduction - Operationalisation Of ‘Futility’ In Two Dutch Nicus: Nicu A. - Operationalisation Of ‘Futility’ In Two Dutch Nicus: Nicu B - Ethical, Legal And Policy Conclusions.


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