According to the authors of a paper published this month in JAMA Internal Medicine, future treatment – ie treatment where the burdens greatly outweigh the benefits, or in a situation where a patient will never survive outside intensive care – is common in critical care units in many developed countries, such as USA, Canada and Europe.
The researchers set out to discover how common this kind of futile treatment is, and how much it costs, by spending three months in five intensive care units (ICU) in American hospitals, assessing how often the doctors considered treatment of their patients to be futile. The study involved 6916 assessments by 36 critical care specialists of 1136 patients.
Of the patients included in the study, 11% were perceived as receiving futile treatment. The number of patients who died in hospital or within six-months were also found to be significantly higher for patients receiving futile treatment. The researchers calculated that the average cost of one day of treatment in ICU was $4004.
Talking to Reuters Health, senior author of the study Dr Neil Wenger said: “Many physicians find that the provision of futile care is not only contradictory to their professional responsibility, but harmful to patients. The biggest issue, more important than the cost issue, is the use of highly advanced medical care that was designed to rescue people that instead gets used to prolong the dying process, such as ventilators and medicines that raise blood pressure.”
“The main message is that early discussions and advance planning are absolutely critical,” he added.
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