Futility and Advance Care Planning at the “End of Life”

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  • Kashiwazaki Ikuko
    立命館大学大学院先端総合学術研究科 東京女子医科大学看護学部

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  • 「人生の最終段階」における無益性の解釈とAdvance Care Planning
  • 「 ジンセイ ノ サイシュウ ダンカイ 」 ニ オケル ムエキセイ ノ カイシャク ト Advance Care Planning

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Abstract

<p>“Guideline on the Medical Care Decision Process at the End of Life” has been generally viewed positively for showing the processes necessary to respect patients’ right to self-determination. However, it has become necessary to reconsider the guideline again from the perspective of the policy for withholding and withdrawing of medical treatment. This paper examines the possible effects of the guideline, focusing on two conceptions of futility and the relationship between the social insurance system and Advance Care Planning (ACP). The result shows that there is some confusion as regards futility conceived as either “logos” or “pathos,” and the social insurance system in relation to ACP arranges for the withholding and withdrawing of medical treatment as an appropriate response because of this confusion. The conclusion reveals that a system is being created in which withholding and withdrawing of medical treatment can occur without conflict.</p>

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