When Doctors Say No: The Battleground of Medical Futility

"The book is a fine addition to the world of academic medical ethics... Readers... will come away with some of the tools for further debate." --Publishers Weekly

"Susan B. Rubin's splendid new book... offers positive, humane solutions to the frustrations that have given rise to the futility debate." --Carl Elliott, Medical Humanities Review

"Rubin offers a thorough and thought-provoking exploration of the concept of futility as a basis for medical decisions." --Choice

"... [the] brilliant analysis found in Rubin's [book] couldn't be more timely.... When Doctors Say No is the most thorough philosophical rebuttal to be found in the literature of medical futility as the basis for unilateral decisionmaking by physicians." --Charles Weijer, Canadian Medical Association Journal

Should physicians be permitted to unilaterally refuse to provide treatment that they deem futile? Even if the patient, or the patient's family, insists that everything possible must be done?

In this book, philosopher and bioethicist Rubin examines this controversial issue. She offers a critique of the concept of medical futility and the debate surrounding it, and she calls for more public debate about the underlying issues at stake for all of us--patients, families, health care providers, insurers, and society at large.

SUSAN B. RUBIN is co-founder of The Ethics Practice, a firm devoted to providing bioethics education, research, and clinical consultation. She has published a number of articles in publications such as The Journal of Clinical Ethics and Theoretical Medicine and is the co-editor of a forthcoming book on mistakes in medicine and ethics consultation.

Chapter One. Whose Facts, Whose Values? An Overview of the Futility Debate

Chapter Two. What Do People Mean By Futility? A Conceptual Analysis

Chapter Three. A Question of Values: The Problem With Evaluative Futility

Chapter Four. The Power of Positivist Thinking: The Problem With Physiological Futility

Chapter Five. After Futility: A Different Kind of Discourse

Notes

Bibliography

Index