BMJ 1995;310:1671-1672 (24 June)

Letters

Ethics and economics of health care

Prognosis, a traditional alternative to futility

EDITOR,--The editorial by Charles Weijer and Carl Elliott and by Richard Smith raised important questions about the ethics and economics of health care.1 2 Weijer and Elliott drew attention to the shortcomings of the new and fashionable concept of futility.1 Medicine, however, is a venerable profession and doctors already have suitable concepts in our traditional toolkit--namely, an awareness of the importance of establishing a precise diagnosis and prognosis. A decision about appropriate treatment can then by taken, after discussion with the patient or a child's parents. It is neither necessary nor appropriate to invoke the issue of rationing limited resources at that stage.

I think that it was here that the arguments about B, the child with leukaemia, became confused.3 The doctors looking after B had come to a diagnosis and prognosis. Cambridge Health Authority muddled the issue by invoking two separate arguments for not . . . [Full text of this article]


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Relevant Article

Pulling the plug on futility
Charles Weijer and Carl Elliott
BMJ 1995 310: 683-684. [Extract] [Full Text]

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