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Medical futility is commonly encountered in small animal clinical practice

Nathan W. Peterson DVM, DACVECC1,2, J. Wesley Boyd MD, PhD2,3, and Lisa Moses VMD, DACVIM (SAIM)2,4,5
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  • 1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
  • | 2 Center for Bioethics, Harvard Medical School, Boston, MA
  • | 3 Psychiatry and Medical Ethics, Baylor College of Medicine, Houston, TX
  • | 4 Faculty of Medicine, Case Western Reserve University, Cleveland, OH
  • | 5 Interdisciplinary Center for Bioethics, Yale University, New Haven, CT

Abstract

OBJECTIVE

To document veterinarians’ perceptions and understanding of medical futility and determine the frequency with which medical futility occurs in small animal practice.

SAMPLE

477 veterinarians in small animal general and specialty veterinary practice.

PROCEDURES

A cross-sectional study was performed with a 25-question, web-based, confidential, anonymous survey distributed through various professional veterinary specialty associations.

RESULTS

Nearly all respondents (469/474 [99.0%]) believed that futile care occurs in veterinary medicine, and 42.4% (201/474) felt it occurred commonly (> 6 times/y). A similar percentage (471/475 [99.2%]) reported encountering futile care within their careers, and 85.0% (402/476) reported encountering it within the past year. A majority (293/477 [61.4%]) reported witnessing futile care occurring in both inpatient and outpatient settings. Most respondents disagreed or strongly disagreed (320/463 [69.1%]) with a statement that providing futile care is always wrong, and only 38 (8.2%) agreed or strongly agreed. Over 70% (329/464 [70.9%]) of respondents agreed that there are situations in which provision of futile care is appropriate.

CLINICAL RELEVANCE

The importance of reaching a consensus definition for medical futility in veterinary medicine is evident given the frequency with which such care is being provided. Most small animal specialist veterinarians will encounter futile care, and the establishment of an ethical framework to navigate questions surrounding medical futility may help reduce moral distress.

Contributor Notes

Corresponding author: Dr. Peterson (nwp26@cornell.edu)