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09/30/2018

Inappropriate Treatment Policies: Central Issues and a Working Example

At 10:30 on Saturday, October 20, 2018, at ASBH 2018, check out “Inappropriate Treatment Policies: Central Issues and a Working Example.”


When a patient or surrogate asks for a treatment or other intervention that the attending physician believes is medically unnecessary or inappropriate, the differences that arise are frequently difficult to resolve. In addition, in such situations, physicians and other caregivers often feel isolated and without institutional support. Yet only a few dozen hospitals/systems have developed institutional policies – sometimes called “futility” or “inappropriate care” policies – aimed at supporting physicians and other caregivers in these ethically and practically difficult situations while assuring that the patient receives treatments that meet the current standard of care. 


XYZ Health System first developed its Medically Unnecessary or Inappropriate Treatment Policy in 2005 and has reviewed and amended the policy twice since then. In this session, three members of XYZ Health System’s Institutional Ethics Committee – a physician/ethicist, a philosopher/ethicist, and a lawyer/ethicist – will begin by describing a typical case in which such a policy might be implemented and explain how XYZ’s policy works. They will then describe the ethical, practical, and institutional challenges that the policy was designed to meet, discuss its relative success so far in meeting them, and describe the changes and adjustments that subsequent review of XYZ’s policy has produced. By comparing a number of institutions’ policies they will identify the key questions that an institution aiming to create such a policy needs to address and explain the conceptual issues involved in properly articulating a policy of this sort. The session will conclude with open discussion of these topics with the audience.


David T. Ozar, Ph.D.
Joseph Gibes, M.D,M.A.
Cavan K. Doyle, J.D., LL.M.

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