Chest
Ethics in Cardiopulmonary MedicineMotivating Factors in Futile Clinical Interventions
Section snippets
Materials and Methods
In 1995, a formal Bioethics Program was instituted at Cedars-Sinai Medical Center. One of its principal functions has been to encourage, organize, and document bioethical consultations. The patient, the patient's family, or any member of the health-care team may request such consultations. The consultation is performed by a specially trained and specially privileged team consisting of a physician, a nurse, and a social worker. Meetings are held with families and health-care providers in an
Clinical Features
The average age of the patients was 73.5 ± 32 years (mean ± 2 SD). Fifty-seven percent of the patients were female, and the remaining 43% were male. The religious makeup was as follows: Jewish, 43%; Catholic, 15%; no religion, 15%; unknown, 12%; other, 8%; and Protestant, 7%. Fifty-seven percent of the patients were admitted with a degenerative disease process, 21% with an inflammatory process, 16% with a neoplastic disorder, and the remaining 6% were admitted secondary to a traumatic event or
Discussion
Our study is unique in evaluating futile and medically inappropriate care on a practical rather than a theoretical basis. We sought to minimize the ambiguity in the definition of futile or medically inappropriate care by selecting patients who died during the hospital stay without a period of marked improvement. This care is most often given to elderly patients with degenerative disease processes. This is not surprising given that these are the patients most likely to have disorders where the
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