The concept of futility in health: A scoping review

Abstract

Introduction:Duetotheconstant scientificandtechnological development, healthprofessionalsareregularlyconfrontedwithsituations inwhichtherearealways therapeuticoptions, regardlessof theseverityof thepatient’scondition.However, regardingthesetherapeuticoptionsas feasible inall situationscanbeharmful, since it isuniversally acceptedthat,despitealladvancesinhealth,thereareinevitablelimitsandthepromotionofsomeinterventionsmaybe uselessor futile. Objective:Tocharacterizetheuseof theconceptof futility inthehealthliterature. Method:ReviewoftheliteraturefollowingtheScopingReviewprotocoloftheJoannaBriggsInstitute.Theresearchwas performed inCINAHL,Cochrane, Pubmed, Scopus eWebof Science to identify studies publishedprior to2020. Nineteenstudieswereselected. Results:There isnouniversallyaccepteddefinition for theconceptof futility. Inthe literature therearedifferent conceptionsfortheconceptoffutilitythatpointtoqualitativeandquantitativerootsandthatareassociatedwithethical dilemmasthatmakeitdifficult toconceptualizethisconceptandmakeitoperational inclinicalpractice. Conclusion:Thecentralelementsoftheconceptof futilityinclude: thediagnosisof futilityiscloselyrelatedtoclinical judgment; futilityhasbothquantitativeandqualitativeroots; futilityisalwaysappreciatedposteriori; futilityisrelatedto thelackofbenefit. It isessential topromoteadiscussionthatenablesthedefinitionof theconceptandthatmakes it possibletopromoteethicalprinciples incare,especiallywhentheinevitablelimitsof treatmentsarereached.