When Doctors Say No: The Battleground of Medical Futility

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The medical situation is critical, even life-threatening. The doctor refuses to offer or to continue providing "futile" medical treatment. The patient, or the patient's family, insists that everything possible must be done. Who should decide? In When Doctors Say No, philosopher and bioethicist Rubin examines this controversial issue. She offers a critique of the concept of medical futility and the dissension surrounding it, and she calls for more public debate about the underlying issues at stake for all of us -- patients, families, health care providers, insurers, and society at large. Despite pressures to set limits, many of them legitimate, Rubin argues that the futility debate and the policies and practices that have evolved in response to it are misguided. She rejects the popular arguments supporting unilateral decision-making by physicians, and calls instead for a different kind of conversation about the central values at stake when doctors and patients so dramatically disagree.