Michelle Fulp

Date of Award

5-1-2007

Document Type

Independent Study

Degree Name

Master of Science (MS)

Department

Nursing

Abstract

While end-of-life and palliative care measures are difficult subjects to address, decision-making for patients and family members becomes more complicated when there is a lack of understanding of when care is appropriate or when it is futile in nature. To date, there is no one definition of what constitutes futile care that is used by health care providers as they counsel patients and family members regarding what is appropriate care at the end-of-life. In fact, the recent debate and media coverage surrounding the Terri Schiavo case in Florida has brought this issue to a national concern. Thus the purpose of this independent study is to begin to develop and apply a definition of futile care and to discover if there are commonalities when a situation is thought to be futile.

The independent study used Imogene King’s theoretical model, specifically the perception component of her model, to begin to define this concept. The study included an in-depth review of the current literature, both research-based and opinion articles to explore this issue. The goal of the study was to better define futile care in terms that health care practitioners and consumers of health care can understand and use in clinical settings. Implications for nursing would include better communications and improve care offered to patients in a variety of clinical settings, as patients at the end-of-life are seen in all clinical settings and among all age groups. By reviewing the literature on certain circumstances of the application of what is thought to be futile, a better working definition of futile care can be developed and patients and family members will hopefully become more informed decision makers. The study concludes with recommendations for nursing practice, research, education, and health policy.

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