ArticleBMC medical ethics2024
Medical futility at the end of life: the first qualitative study of ethical decision-making methods among Turkish doctors.
Article in BMC medical ethics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Patterns of Care in the Final Week of Life: A Comparative Analysis of Aggressive Treatment Versus Comfort-Centered Care Across Healthcare Settings.Medicina (Kaunas, Lithuania) · 2026Article
- Temporal distribution of recorded intensive care unit deaths across the 24-hour cycle: a 15-year retrospective hospital-based study.BMC anesthesiology · 2026Observational
- Structural tensions between health policy and medical ethics: a qualitative study of physicians' experiences under Türkiye's health transformation programme.BMC medical ethics · 2026Article
- How do intensive care physicians wish to die? A cross-sectional study on end-of-life preferences and the role of palliative care.Frontiers in medicine · 2026Article
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Authors and funding
2 authors.
Funding
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Abstract
backgroundThe swift advancement of intensive care medicine, coupled with technological possibilities, has prompted numerous ethical inquiries regarding decision-making processes concerning the withholding or withdrawal of treatment due to medical futility. This study seeks to delineate the decision-making approaches employed by intensive care physicians in Türkiye when faced with medical futility at the end of life, along with an ethical evaluation of these practices.
methodsGrounded theory, a qualitative analysis method was employed, conducting semi-structured, in-depth interviews with eleven intensive care physicians in Türkiye. The subsequent text analysis was carried out using MAXQDA software.
resultsParticipants assert that the decisions made by Turkish physicians determine whether treatment is futile, rely on medical consensus, and lack a standardized decision-making process. The decisions are influenced by legal and social pressures, resource constraints, and occasional conflicts of interest. The significance of professional hierarchy is notable, with limited consideration given to the opinions of nurses and other staff. The unstructured medical consensus processes are shaped by normative concepts such as benefit, age, justice, and conscience. Furthermore, it was observed that the conscientious opinions of physicians carry more weight than adherence to ethical principles and guidelines.
conclusionTo create optimal conditions for doctors to make ethically justifiable decisions, the dynamics within the treatment team should be improved, emphasizing the minimization of hierarchy, and ensuring the active participation of all team members in the decision-making process. Additionally, efforts should be directed toward narrowing the gap between the conscience of the individual doctor and established ethical principles. A potential solution lies in the nationwide implementation of clinical ethics committees and the establishing of clinical ethics guidelines, aiming to address, and overcome the identified challenges.
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