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Medical Futility: Where's the Attending?

Robert Matz, MD
Arch Intern Med. 1992;152(12):2505-2506. doi:10.1001/archinte.1992.00400240117021.
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To the Editor.—  The article by Jecker and Pearlman1 regarding medical futility left me with a cold empty feeling in the pit of my stomach.If a perceptive gerontologist and ethicist are capable of writing about the "house-staff physicians" concerns about medical futility and the "gastroenterology service" opinions without any mention of an attending physician, we are in deeper trouble than I thought.Nowhere is there any evidence of the involvement of the attending physician in these deliberations. If ever there was an argument for an individual who is mature, compassionate, medically knowledgeable, experienced, willing to accept responsibility, capable of weighing the often nebulous concepts of quality of life and medical futility, it is this situation. This is the essence of caring and of the care of the patient, and it is the primary responsibility of the attending physician—not some anonymous conglomerate of "house-staff physicians" or a "gastroenterology service"

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