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How Physicians Talk about Futility: Making Words Mean Too Many Things

Published online by Cambridge University Press:  01 January 2021

Mildred Z. Solomon
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Extract

“There's glory for you!”

“I don't know what you mean by ‘glory,’ ” Alice said.

Humpty Dumpty smiled contemptuously. “Of course, you dont—till I tell you. I meant ‘there's a nice knock-down argument.’”

“But ‘glory’ doesn't mean a ‘nice knock-down argument,” Alice objected.

“When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean—neither more nor less.”

“The question is,” said Alice, “whether you can make words mean so many different things.”

“The question is,” said Humpty Dumpty, “which is to be master, that's all.”

When applied bioethics confronts the topic of futility, the question of who is to be master turns out to be central. Indeed, much of the literature on futility has focused on exactly this question: who gets to define the terms of the debate? Who gets to decide that treatment is “futile” and therefore allowably withheld or withdrawn?

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 21 , Issue 2 , Summer 1993 , pp. 231 - 237
Copyright
Copyright © American Society of Law, Medicine and Ethics 1993

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References

Rebecca Jackson, Associate Director of Decisions Near the End of Life, and Andrea Carlos, Research Associate, ably assisted with the interviews. I am grateful to the Director of Continuing Medical Education at the hospital for his help and to the physicians who spoke so sincerely about the dilemmas they confront in their practice. This work was supported, in part, by a grant from the W.K. Kellogg Foundation. Earlier versions were presented at the 1991 Annual Meeting of the American Public Health Association’s Bioethics Forum in Atlanta, Georgia and at the 1992 Decisions Near the End of Life national training conference in Albuquerque, New Mexico.Google Scholar
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