The purpose of the concept Analysis
Medical futility is a controversial issue that has been in existence for several years (Aghabarary & Nayeri, 2016). Decisions regarding futile care need effective communication and respect for the wishes of the parents. The decision is shared between the patient and the doctors, and in cases of children, between the patients’ family and the doctors (Leeuwenburgh-Pronk et al., 2015). Though numerous research studies have been conducted in an attempt to identify border specifications of futile care, there remains a lack of a unified definition of futile care. Barhamnezhad et al. (2014) therefore conducted this concept analysis in an attempt to provide a more vivid and more explicit description of medical futility as well as its concept and its features. Provision of a unified definition will thereby enhance realistic interventions for patients and hence reduce instances where futile care.
Critical Attributes Assigned to The Concept
Barhamnezhad et al. (2014) assigned several essential attributes to the concept of futile care: A patients’ low quality of life, lack of physiologic return and performance of non-professional duties by nurses. The article explains that in most cases when futile care s offered, it is to patients with a low-quality life. Offering therapeutic and care-related services to individuals who would afterward require life support machines for survival is also considered futile care. When a patient is unable to survive even after medical care has been provided, then this is labeled as lack of physiologic return, and it constitutes futile care. Medical care that does not lead to an improved patient outcome is regarded as futile care The article also stipulates that in most cases nurse lack a professional checklist of what they should be doing for the patient and therefore, they end up performing actions that are not beneficial for the patient, which constitutes futile care.
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The Implications for Nursing Practice
Nurses have the responsibility of empowering parents, by helping them decide on whether to continue palliative care or to withhold life sustenance. Therefore, have a unified definition of what medical futility is can provide nurses with relevant information that they can share with patients and their families. In addition to this, having a clear definition of futile care can ensure that nurses provide clinical services that are relevant to their work. It would also ensure that nurses are not involved in the provision of medical care that cannot revive the patient physiologically or qualitatively. Besides, futile care is mostly associated with negative consequences such as the patient’s family emotional and economic burden, which lead to nurse dissatisfaction. A clear definition of the concept will prevent frequent occurrences of such consequences which in turn will result in nursing job satisfaction (Barhamnezhad et al., 2014).
Why This Particular Concept was Chosen and its Relevance to my Phenomenon of Interest (POI) and Practice
My previously discussed POI was about “Effects of Medical Futility in The Care of Critically Ill Pediatric Patients." I chose this article "Futile Care; Concept Analysis Based on a Hybrid Model” by Barhamnezhad et al. (2014) because it provides a more vivid definition of what futile care is, and what its characteristics are. I believe that futile care is still a controversial issue in this modern world because of the non-specification of borders with regards to futile care. The series of arguments expressed concerning futile care is because of the wide range of professional groups that have an opinion about futile care. These include law, politics, ethics among other, and in addition to this, different cultural contexts, as well as religious beliefs, view the issue differently. Therefore, I selected this article because it utilizes the Hybrid Model, which helps in clarification, identification, analysis, and refinement of concepts, to provide a clear definition of futile care and its features.
This concept analysis is relevant to my POI which is about critically ill pediatric patients as well as practice because children with life-threatening conditions who have minimal chances of recovery leave their care teams as well as their parents in a dilemma since they are torn between withdrawing treatment and sustaining life (Jecker, 2011). Having a vivid definition of futile care, therefore, ensures that nurses do not continue to provide expensive medical care and treatment for pediatric patients while raising the parent’s hope when there is no chance of recovery (Morparia, Dickerman, & Hoehn, 2012). Moreover, the article emphasizes the importance of a clear checklist of duties for nurses to ensure that they do not provide futile care.
How This Concept Analysis Impacts the Way I View My POI?
The concept analysis by Bahramnezhad et al. (2014) provides a clear insight into the definition of futile care and its attributes. Medical treatments are expected to preserve life and promote health through the provision of the right medical intervention. Provision of the proper medical intervention can be through withholding life or instigating it (Morparia et al., 2012). Either way, all interventions should be directed towards comfort, pain relief, and respect for dignity. Medical interventions that do not resuscitate the patient physiologically or qualitatively are futile, and there is no justification whatsoever, of continuing to offer such medical care to critically ill pediatric patient (Lotz, Jox, Meurer, Borasio, & Führer, 2016).
A new insight gained from reviewing this article is the negative consequences associated with futile medical care more specifically emotional and economic burden. Healthcare professionals are tasked with life maintenance; however, if sustaining life only prolongs the suffering of an individual, then it is within their rights to make a right decision while balancing the benefits and the burden associated with the treatment (Lotz et al., 2016). In conclusion, therefore, this concept analysis has provided some helpful insights with regards to futile medical care in pediatric patients. A significant point clarified by this analysis is the definition of futile care. My viewpoint on futile care in pediatric patients has not changed due to this analysis. It is still in my professional belief that choosing to continue futile care on a pediatric patient is unethical and having a clear understanding of futile care can help nurses provide parents with relevant information and hence help them make the best choice for a critically ill pediatric patient.
References
Aghabarary, M., & Nayeri, N. D. (2016). Nursesʼ Perceptions of Futile Care. Holistic Nursing Practice , 30 (1), 25-32. doi:10.1097/hnp.0000000000000128
Bahramnezhad, F., Cheraghi, M. A., Salsali, M., Asgari, P., Khoshnava Fomani, F., Sanjari, M., & Farokhnezhad Afshar, P. (2014). Futile Care; Concept Analysis Based on a Hybrid Model. Global Journal of Health Science, 6(5). doi:10.5539/gjhs.v6n5p301
Jecker, N. S. (2011). Medical Futility and the Death of a Child. Journal of Bioethical Inquiry , 8 (2), 133-139. doi:10.1007/s11673-011-9288-0
Leeuwenburgh-Pronk, W. G., Miller-Smith, L., Forman, V., Lantos, J. D., Tibboel, D., & Buysse, C. (2015). Are We Allowed to Discontinue Medical Treatment in This Child? PEDIATRICS , 135 (3), 545-549. doi:10.1542/peds.2014-0548
Lotz, J. D., Jox, R. J., Meurer, C., Borasio, G. D., & Führer, M. (2016). Medical indication regarding life-sustaining treatment for children: Focus groups with clinicians. Palliative Medicine , 30 (10), 960-970. doi:10.1177/0269216316628422
Morparia, K., Dickerman, M., & Hoehn, K. S. (2012). Futility. Pediatric Critical Care Medicine , 13 (5), e311-e315. doi:10.1097/pcc.0b013e31824ea12c
