A new study shows that more medical futility cases are going to court in France: Intractable conflicts over end-of-life decisions: A descriptive and ethical analysis of French case-law.
In contrast to UK experience where the NHS has a 90+% success rate, French clinicians lose nearly 40% of their cases. Most of these cases are withdrawal decisions rather than withholding decisions. And most (>75%) are for neurological reasons (e.g., severe DOC).
Families challenge the clinicians' therapeutic obstinacy determination on two types of grounds:
- Qualification of “unreasonable obstinacy"
- Medical and prognostic uncertainty
- Acceptance of quality of life/disability
- Absence of suffering
- Non-compliance with the decision-making process
- Failure to inform relatives
- Inappropriate “consultant” physician
- Failure to consider the opinion of relatives
- No collegial procedure
- Failure to consider the patient’s wishes
- No traceability in the medical record
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