Beyond Autonomy – Physicians' Refusal to Use Life-Prolonging Extracorporeal Membrane Oxygenation

Three years ago we noted that the literature on physicians' refusal to provide requested treatment was sparse¹. Since that time the issue has fueled an intense, two-pronged debate – on futility and on the limits of patient autonomy. The debate over patient autonomy is a genuinely philosophical dispute; that over futility seems to be a relapse into nominalism. It is not the meaning of a word but the moral basis for the actions of the participants that ought to be the focus of our attention. The fractious debate on the meaning of futility, evidenced in a spate of recent…