16. Medical Futility

This chapter begins with a discussion of the concept of medical futility. It examines cases dealing with selective non-treatment of the newborn and selective non-treatment in infancy. The chapter argues that while concepts such as ‘futility’ and ‘best interests’ have strong normative appeal, the search for objectivity in their application may itself be a futile exercise. The reality is that decision-makers are involved in a value-laden process, and this is no less true when the decision is taken in a court rather than at the patient’s bedside. The chapter then considers the issue of end of life, examining cases of patients in a permanent vegetative state and those in a minimally conscious state.

Are there dead persons?

Schechtman’s ‘Person Life View’ (PLV) offers an account of personal identity whereby persons are the unified loci of our practical and ethical judgment. PLV also recognises infants and permanent vegetative state patients as being persons. I argue that the way PLV handles these cases yields an unexpected result: the dead also remain persons, contrary to the widely-accepted ‘Termination Thesis.’ Even more surprisingly, this actually counts in PLV’s favor: in light of our social and ethical practices which treat the dead as moral patients, PLV gives a more plausible account of the status of the dead than its rival theories.