Futile and/or useless medical care: From anguisH to tHeserenity oF a bioetHical balance

Abstract

Prolonging the painful dying process, which adds suffering and prorogues deathmore than it extends life, is one of the most complex and debated bioethical issuestoday, in the context of end-of-life care. The complexity starts in the definition ofthis bioethical problem in itself. our search is marked by “creative anguish” (notthe pathological one, which paralyzes us in face of life), whose objective is toidentify numerous terms and neologisms to nominate and define the bioethicalissue: dysthanasia, futile medicine and/or treatment, to define diagnostic andtherapeutic intervention that does not bring any benefits to patients in their finalstage of life. To solve this bioethical problem, we have relied on medical andscientific literature and on international bioethics literature, as well as on thetradition of the Brazilian medical ethics, in its codified version. Although acertain treatment can be considered futile and therefore useless, health care willnever be futile and useless. In the heart of every single action of healthcaregiving, there must be “philia” (love, friendship). We can surely be cured froma deadly illness, but not from our mortality and finality. our existing status is nota pathology. When we forget this, we fall into the technolatry realm, and theinstruments for cure and healthcare easily become torture tools. This articleintends to present a methodology to deal with these ethically conflictive situationsby going deep into some essential ethical concepts, such as the process ofdeliberation, decision-making and medical responsibility, and the role ofbioethics committees. The search for a suitable balance helps us throughout theroute that goes from anguish to serenity.