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Futility: A Concept in Search of a Definition

Published online by Cambridge University Press:  29 April 2021

Extract

In the landmark case of Crzan v. Director, Missouri Department of Health; the United States Supreme Court went out of its way to emphasize that the state was paying for Nancy Cruzan's care. The court refused to allow removal of the artificial nutrition and hydration that was maintaining Nancy Cruzan in a persistent vegetative state (PVS). What if, instead of the state's paying for the care, the parents had to “spend down” in order to be eligible for Medicaid? Could the state opt for life and require the family to pay for the care? If not, do constitutional rights depend on who can or will pay the cost of care?

Now turn the facts of Cruzan around and assume that the parents want to keep the child alive. Could the parents force the state to bear the cost of keeping a PVS patient alive indefinitely? If not, why should the state, but not the parents, have a constitutional right to preserve life? Do constitutional rights boil down to dollars?

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1992

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References

110 S.Ct. 2841 (1990).Google Scholar
Hastings Center, Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying, Bloomington: Indiana University Press, 1987:32.Google Scholar
Truog, R.D., Brett, A.S., Frader, J., “The Problem with Futility,” N. Eng. J. Med. 1991; 326:15601564.CrossRefGoogle Scholar
Solomon, M.Z., Life and Death Decisions: Physician Perspectives and Their Implications for Professional Education, Ann Arbor, Michigan: U. Michigan Intl. 1991.Google Scholar
Solomon, M.Z., “Futility as a Criterion in Limiting Treatment,” (letter) N. Eng. J. Med. 1991;327(17):1239.Google Scholar
Capron, A.M., “Oregon's Disability: Principles or Politics?” Hastings Cen. Rep. 1992; 22(6):1820.CrossRefGoogle Scholar
Gostin, L., “The Americans with Disabilities Act and the U.S. Health Care System,” Health Affairs 1992;11(3):248257.Google Scholar
Weir, R.F., Abating Treatment with Critically III Patients: Ethical and Legal Limits to the Medical Prolongation of Life. Oxford University Press, 1989.Google Scholar