Futility as a Criterion in Limiting Treatment

To the Editor: In their Sounding Board article (June 4 issue),¹ Truog et al. convincingly argue that the concept of futility is ill suited to be a rationale for limiting life-sustaining treatments: use of the concept too often obscures the value choices inherent in decisions to terminate treatment. As the authors put it, “the problem with futility is that its promise of objectivity can rarely be fulfilled.” Empirical research I conducted with physicians at a Harvard teaching hospital² and experience working with doctors around the country³ bear out that conclusion and shed light on why the promise of objectivity is…