ReviewCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne1998
Bioethics for clinicians: 16. Dealing with demands for inappropriate treatment.
Review in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Part 3: Ethics: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2025Guideline
- Navigating Patient-Initiated Non-Standard Care (PINSC) Requests: Applying an Ethically Coherent Framework for Shared Decision-Making.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Ethics and the 2018 Practice Guideline on Disorders of Consciousness: A Framework for Responsible Implementation.Neurology · 2022Article
- Conceptualization of Idle (Laghw) and its relation to medical futility.Journal of medical ethics and history of medicine · 2016Article
- Perceptions of the appropriateness of care in California adult intensive care units.Critical care (London, England) · 2015Article
- Article
- Ethics roundtable debate: patients and surrogates want 'everything done'--what does 'everything' mean?Critical care (London, England) · 2006Review
- Determining resuscitation preferences of elderly inpatients: a review of the literature.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2003Review
- Characterizing patient requests and physician responses in office practice.Health services research · 2002Article
Corrections and comments
- Commented on by
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Demands by Patients or their Families for treatment thought to be inappropriate by health care providers constitute an important set of moral problems in clinical practice. A variety of approaches to such cases have been described in the literature, including medical futility, standard of care and negotiation. Medical futility fails because it confounds morally distinct cases: demand for an ineffective treatment and demand for an effective treatment that supports a controversial end (e.g., permanent unconsciousness). Medical futility is not necessary in the first case and is harmful in the second. Ineffective treatment falls outside the standard of care, and thus health care workers have no obligation to provide it. Demands for treatment that supports controversial ends are difficult cases best addressed through open communication, negotiation and the use of conflict-resolution techniques. Institutions should ensure that fair and unambiguous procedures for dealing with such cases are laid out in policy statements.
Indexed as
Identifiers
9805031PMC1232742What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.