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A Preventive Ethics Approach to Counseling Patients About Clinical Futility in the Primary Care Setting
David J. Doukas, MD;
Laurence B. McCullough, PhD
Arch Fam Med. 1996;5(10):589-592.
Abstract
Given the current themes of futility and managed care in medicine and bioethics, the primary care setting needs to account for how to address futility. We argue for applying the concept of clinical futility to primary care medicine. A preventive ethics approach directs the primary care physician to explain and counsel against futile interventions, with a negotiation strategy for circumstances of disagreement. These efforts will require primary care physicians to concentrate their efforts on education, negotiation, and enhanced trust in their patient relationships. Using a preventive ethics approach in these circumstances, the physician can better protect the interests of the patient by avoiding nonbeneficial interventions, especially those that also are potentially harmful.
Author Affiliations
From the Department of Family Practice and the Program in Society and Medicine, University of Michigan, Ann Arbor (Dr Doukas); and the Center for Medical Ethics and Public Policy, Baylor College of Medicine, Houston, Tex (Dr McCullough).
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