Futility

In this era of increasingly cost-conscious health care, there has been much discussion about end-of-life care. The statistics behind the disproportionate expenditure in the terminal months of life and the accompanying dismal clinical outcomes have become a staple of any presentation on the topic. Although this sort of fine economic and policy analysis has provided insight into the problem, it neglects an essentially human barrier to avoiding futile care, a problem that was brought home to me as a resident on a recent surgery call.

The consult for Ms. K came late at night. It was from the cardiac surgery ...