Which mechanism is commonly used to resolve disputes about continuing aggressive treatment when there is disagreement about futility?

• A. Immediate withdrawal by physician without discussion.
• B. Continue all treatments regardless of outcome.
• C. Death is inevitable; no intervention.
• D. Ethics consultations, patient/surrogate input, and sometimes court or institutional policy.

Answer: (D)

Disputes about futility are resolved through a structured, collaborative process that combines ethics consultations, input from the patient or surrogate, and, if needed, court or institutional policy. An ethics consultation provides an impartial analysis of prognosis, benefits and burdens of continuing aggressive treatment, and how those factors align with the patient’s values and goals. Involving the patient or surrogate ensures decisions reflect autonomy and previously expressed wishes. If consensus still can’t be reached, formal mechanisms such as court involvement or established hospital policies guide the decision, protecting patient rights and ensuring consistent, legally grounded practice. This holistic approach is preferable to withdrawing without discussion, continuing all treatments regardless of outcome, or assuming death is inevitable without a formal process.