British medicine has lessons for North American medicine

doi:10.1136/bmj.310.6995.1672

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Kevin Stewart,
Adrian Wagg,
Mark Kinirons

Consultant physician Newham General Hospital, London E13 8RU
Senior registrar in geriatric medicine University College London Hospitals NHS Trust, London WC1E 6DB
Lecturer Department of Medicine for the Elderly, King's College Hospital, London SE5 9RS

EDITOR,—The editorial on futility by Charles Weijer and Carl Elliott had a distinctly North American flavour, which will limit its relevance to British clinicians.1 We do not agree that withdrawing life supporting care from a patient in a persistent vegetative state presents a dilemma; it is common sense to us that such care is futile.

The context in which such decisions are made in North America, or in the United States at least, is …