Running head: PROVIDING FUTILE CARE

Providing Futile Care
Julia McGraw
Lakeview College of Nursing
N-200 Theories and Issues in Nursing
March 13, 2011

PROVIDING FUTILE CARE
Providing Futile Care
       Providing futile care to patients can be quite stressful on those in the healthcare profession, especially nurses.  We will discuss the ethical issues behind futile care and the implications it has on the nursing profession.  We will also discuss some of the challenges that nurses go through when delivering this type of care to patients.  Also, we will touch base on several of the ethical principles that apply to delivering futile care.
       There are many different beliefs when it comes to futile care.  Futile care is giving a patient who is terminally ill aggressive treatment, which is delaying the inevitable, death.  The patient may go through a great deal of unnecessary pain and the patient’s family is given false hope.  This not only has a huge impact on the patient and his or her family, but on the entire healthcare team working with the patient as well.  (Rice, Rady, Hamrick, Verheijde, & Pendergast., 2008, p. 362)
       Nurses are usually the primary care givers to the patient.  They deliver the ordered care and many times this goes against their own beliefs, religious and personal.  Nurses are also seeing and speaking with patient’s family members.  They see the false hope that it gives to the family.  They also have to speak to the family about his or her patient’s care.  Not only is this putting strain on the nurses, but it is also taking away valuable time and money which could be put towards a person who has a chance of getting well and leading a long and happy life.  (Ferrell, 2006, p. 924)
       There are several ethical principles that should be addressed when looking at the ethics behind futile care.  One of these principles is autonomy.  Autonomy means that a person should 

PROVIDING FUTILE CARE
be able to make one’s own decisions and courses of action regarding his or her own life. (Chitty & Black., 2011, p. 108)
       Many times in futile care the patient has little or no input regarding his or her wishes.  The patient may not be coherent, so family members are making the decisions for him or her.  Also, his or her doctor and family members may be pushing the patient to a decision that does not fit one’s own desires.   (Ferrell, 2006, p. 924)
       Another ethical philosophy that applies to futile care is beneficence.  Beneficence is providing what is of best interest to the patient.  At times this can have some negative consequences on the patient.  In the end, this provides healing or safety and less harm to the patient.  (Chitty & Black., 2011, p. 108)
       While providing futile care, there is no healing.  There are no safety issues that are being addressed.  The care is causing more harm than good in most cases.  The care lengthens the time of family, nurses, and most of all the patient’s stress and pain.  (Rice et al., 2008, p. 362)
       Justice is another ethical philosophy that should be addressed when looking at futile care.  Justice is giving care according to the patient’s illness and his or her needs.  Justice also looks at the outcomes that the care will bring.  (Chitty & Black., 2011, p. 109)
       With futile care, the care that is being given is not meeting the person’s needs.  It is just filling a void, whether it be the doctor’s or the patient’s family, so they know they feel that they have done all that they could for the person. We are giving care to a person that is not going to survive.  It many delay death for a time but death is ultimately in the person’s near future.  This time could have been spent on someone who had a decent chance of regaining health and 

PROVIDING FUTILE CARE
contributing to society.  It us unfair to give so much time to someone when there is no chance of survival and sending others away who could live.  (Ferrell, 2006, p. 923)
       Paternalism is an ethical philosophy that we must also address when discussing futile care.  Paternalism is when a person does not tell another the absolute truth or leaves out an entire subject because they do not think that the other person would understand or could not handle the truth.  In the healthcare system, healthcare workers must tell their patients the truth about their illnesses.  It is not our decision as to whether we want to tell the patient or whether they are capable of understanding the condition.  It is also not up to the healthcare worker to withhold information because it could upset the patient or the fact that the patient may not handle the news well.  It is the healthcare worker’s job to inform the patient about his or her condition.  It is the patient’s body and it is the patient’s life that will be affected in the end.  (Chitty & Black., 2011, p. 112)
       When providing futile care, it is the healthcare worker’s job to inform the patient or if the patient is incoherent, his or her family, the patient’s condition and where the patient stands with the illness.  The healthcare worker must not leave out what would be hard for the patient or his or her family members to hear.  The patient and/or the family must be informed accurately and precisely so they know what to expect and can be better prepare for the hardships to come.  In some cases the patient’s family many ask the nurse not to tell the patient the seriousness of the problem at hand.  This can be a huge burden on the nurse and go against the nurse’s own beliefs.   (Rice et al., 2008, p. 362)
       Veracity is the last ethical principle that we will address.  Veracity is being honest to your patient.  A nurse should be honest with his or her patient.  This provides a trusting and 
PROVIDING FUTILE CARE
open relationship between the nurse and his or her patient.  This will provide for a better care and the patient will be more confident with one’s care that he or she is receiving.  By also being honest with the patient’s family, will help them deal with their loved one’s illness and many times come to terms with what is to come.  (Meltzer & Huckabay., 2004, p. 202)
       It is especially important when a nurse is providing futile care to a patient.  The patient will be kept informed on his or her condition.  Also, the patient will feel more comfortable asking his or her nurse questions about his or her illness or care that is being received.  The patient would know right where he or she stands on recovery and truly trust the information that they have received, to make the best decisions for his or herself. (Chitty & Black., 2011, p. 110)
       Futile care can be very stressful on the entire healthcare team, the patient, and the patient’s family.  This can be especially hard on nurses.  When nurses are providing futile care there are several ethical principles that should be addressed.  These ethical principles include autonomy, beneficence, paternalism, justice and veracity.  Providing futile care has a huge impact on nurses.  Thus it is very important for nurses to understand healthcare ethics and know where he or she stands on futile care.

PROVIDNG FUTILE CARE
References
Chitty, K., & Black, B. (2011). Professional nursing: Concepts and challenges (6th Ed.). 
       Maryland Heights, MO: Saunders Elsevier
Ferrell, B. (2006). Journal club. Understanding the moral distress of nurses witnessing medically    
       futile care. Oncology Nursing Forum, 33(5), 922-930. Retrieved from 
       EBSCOhost.
Meltzer, L., & Huckabay, L. (2004). Critical care nurses' perceptions of futile care and its effect 
       on burnout. American Journal of Critical Care, 13(3), 202-208. Retrieved from EBSCOhost.
Rice, E., Rady, M., Hamrick, A., Verheijde, J., & Pendergast, D. (2008). Determinants of moral 
       distress in medical and surgical nurses at an adult acute tertiary care hospital. Journal of    
       Nursing Management, 16(3), 360-373. Retrieved from EBSCOhost.