The Australian Capital Territory Local Hospital Network Council has a legislative mandate to consult with the community on any issues affecting the satisfactory delivery of health services, and the overall performance of the local hospital network at least once per year, prior to presenting the ACT Health Minister with the Council’s Annual Report.
In a recent report, the Council made the following recommendation:
Regardless of consumers having an ACP, the LHN should create systems within hospitals and RACFs which enable futile care to be legitimately recognised and which more easily enable clinicians to cease such care and redirect patients to palliative / end-of-life care.
This recommendation was based on a World Cafe session in which participants observed:
There needs to medical/legal community recognition that some care is futile, that it will not extend the quality of life of the patient. There should be clear processes developed, backed by the health service and with suitable safeguards, that acknowledge such care is pointless and wasteful of health system resources (that could add much more benefit elsewhere). Such processes should legitimate the withdrawal of interventions (except palliative ones) for the sake of the consumer, clinicians and the service.
The Council defined "Futile Care" as
the continued provision of medical care or treatment to a patient where there is no reasonable hope of a cure or benefit. This can include a surgeon operating on a patient with terminal cancer where there is no palliative benefit, or doctors sustaining life in patients with no meaningful brain activity for reasons other than organ retrieval.
Apart from using the term "futile care" instead of "futile intervention," the ACT's basic recommendation is sound. The problem, of course, will be implementing the vague definition.
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