New Regulations Define "Medical Futility" with Precision

For thirty years, numerous guidelines, recommendations, and laws have stated that clinicians are not obligated to provide "medically ineffective" or "futile" treatments. But few have been able to implement such rules, because of significant uncertainty and variability over exactly which treatments fall into this category. That has generally chilled and deterred clinicians from using "medical futility" laws. 

Now the concept of "medical futility" is being used in new abortion laws. While these laws generally prohibit abortions, they except situations where the pregnancy is "medically futile" such that the unborn child has a condition "incompatible with sustaining life" after birth. But as we saw in the end-of-life ICU context, these clinicians are similarly uncertain over exactly which conditions fall into the "medical futility" category.

To provide the level of clarity that clinicians want, some of these states have promulgated regulations that list dozens of specific conditions that qualify as "medically futile." I recently commented on a Rule published by the Louisiana Department of Health, arguing the initial list is both over-inclusive and under-inclusive.