Requests for Nonbeneficial Treatment (DRAFT)

The 1990s were termed the “futility decade” because of greater interest in cases where the patient demands treatment that the physician is reluctant to provide. In many ways this was the converse of the “right to die” movement of the 1970s and 1980s, except it did not lead to resolution because of definitional and practical barriers. The concept of nonbeneficial treatment—a more acceptable term—has recently received additional attention in the context of soaring health care costs. Some states have proposed clear and definitive mechanisms for adjudicating such disputes (such as the Texas Advance Directives Act). Each institution should have its own policy that can be modeled after a recent consensus statement on the topic.