Futile treatment under spotlight

New research will examine the legal, human and economic impacts of treatment given to dying patients.

Queensland researchers have launched a three year project to examine why futile medical treatment is, at times, provided to dying patients.

The study will be conducted by a cross-disciplinary team of academics from QUT and the University of Queensland, in partnership with the Royal Brisbane and Women's Hospital.

The research, lead by Professor Lindy Willmott and Associate Professor Ben White from QUT's Health Law Research Program, will reveal why treatment which is considered unnecessary from a strictly medical point of view is sometimes provided.

Willmott said administering treatment to those coming to the end of their life through either diagnosed illnesses or sudden accidents was a complex issue, and could affect the quality of the patient's dying experience. She said providing futile treatment could also have adverse effects on the health professionals involved with giving such treatment.

Wilmott said this would be the first comprehensive study to determine the size of the issue and the best ways of dealing with it. Limited research has been conducted in the US and Canada, and anecdotal evidence collected in Australia.

"We know patients near their deaths are sometimes provided with treatment that may not be in their best interests, and that simply delays the dying process," she said.

White said such treatment appeared to be performed for a range of reasons including doctors' concern about the potential legal liability of not providing treatment, especially when family members insisted in it.

"When a loved one is dying a range of complex family issues can come into play, for example with family members who may not have seen the patient for a long time and are unprepared for them to die," he said.

"The delivery of care appears also to be influenced by doctors' perceptions of patient death as a failure, uncertainty about what patients who are now unable to communicate would have wanted, communication issues between specialists when a patient is being treated for a range of illnesses, as well as a doctor's religious views."

He said the delivery of futile medical treatment to the dying would also be looked at from an economic point of view to gauge how often it occurred and the cost of providing the treatment.

The three year study, 'Futile treatment at the end of life: legal, policy, sociological and economic perspectives' has been granted $260,000 from the Australian Research Council.

It will incorporate a legal and policy review to gauge the context in which current end of life treatments are made. Researchers will also conduct in-depth interviews with doctors, including those in intensive care, emergency, palliative care and oncology, in a range of hospitals to determine why and how often they provide treatment that they don't consider to benefit the patient.

An audit of patient charts over a six month period will also be conducted to determine the frequency and cost of such care.

Willmott said at the conclusion of the research the team expected to have evidence to identify the extent to which unnecessary treatment was being provided, its cost and suggestions for addressing its causes.

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