Defense Date

3-28-2017

Graduation Date

Spring 1-1-2017

Availability

One-year Embargo

Submission Type

dissertation

Degree Name

PhD

Department

Health Care Ethics

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Gerard Magill

Committee Member

Henk ten Have

Committee Member

Joris Gielen

Keywords

Age Continuum, Ethics, Futility

Abstract

Much has been written on the topic of medical futility with reports of its existence dating back to the time of Hippocrates. However, the majority of the research on the topic has been on the adult population. Very little literature addresses the presence of medically futile treatment across the age continuum identifying issues that impact neonates, pediatrics, as well as adults.

This dissertation addresses the gap in the literature by considering the ethical problem of medical futility across the age continuum. By addressing the common thread of futility, there is an imperative for a call to action that encompasses the span of organizational ethics. This span not only includes the clinical and professional ethics, but also the business ethics.

A broad review of the literature on both medical futility and moral distress was accomplished. This yielded an integrative approach to the ethics of medical futility at the end-of-life across the age continuum as well as its effect on the moral distress of the nurses caring for these patients.

Findings indicate that medical futility, or inappropriate medical treatments at the end-of-life, are to be found in all critical care units across the age continuum. Although there are commonalities, each age group contends with ethical dilemmas surrounding the ethics of inappropriate medical treatments that are specific to their age group. The inappropriate medical treatments are not only the number one cause of moral distress in nurses, but also create moral distress for physicians and other allied health professionals.

Increasing the conversation across the age continuum, that begins in nursing and medical schools, is needed to increase the awareness of medical futility and develop strategies to confront it. Improving communication, plus the use of advance directives and palliative care for all age groups, holds the greatest hope for the future in minimizing futile treatments at the end-of-life.

Format

PDF

Language

English

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