Letters

Medical ethics Identifying futile treatment is ethical

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6957.810 (Published 24 September 1994) Cite this as: BMJ 1994;309:810
  1. D J Bihari
  1. Intensive Care Unit, Guy's Hospital, London SE1 9RT
  2. Department of Human Science and Medical Ethics, Medical Colleges of St Bartholomew's and the Royal London Hospitals, London EC1.

    EDITOR, - I find it extraordinary that the British Medical Association's medical ethics committee should condemn a computerised system for predicting outcome in the intensive care unit as unethical without attempting to contact the doctor involved in its application.1 The facts of the matter are simple. Intensive care beds are in short supply in Britain, and many patients are refused admission to the intensive care units. Because of this shortage of resources, difficult decisions have to be made about the appropriateness of treating patients who are critically ill. Any system that allows the attending physician to identify earlier a patient who is hopelessly ill deserves attention. The doctors' goals are twofold: to identify futile intensive care earlier so as to alleviate the suffering of patients who are inevitably going to die and to withdraw treatment in such hopeless cases earlier so as to make more efficient use of the scarce resource.

    I believe that the challenge for those of us who work in intensive care in Britain is not only to argue strongly for more resources (which I do incessantly at Guy's Hospital) but also to improve the way we practise our medicine. How can this be unethical?

    References

    1. 1.

    New technology will always pose dilemmas

    1. P Toon
    1. Intensive Care Unit, Guy's Hospital, London SE1 9RT
    2. Department of Human Science and Medical Ethics, Medical Colleges of St Bartholomew's and the Royal London Hospitals, London EC1.

      EDITOR, - The debate in the media about the computer program that calculates prognoses for patients in …

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