Intensive Care - Absence of Generally Accepted Healthcare Standards

One of the insightful "Murphy's Laws" is Leahy's Law: If a thing is done wrong often enough, it becomes right.

This succinctly captures a key legal obstacle to critical care physicians unilaterally refusing life-sustaining treatment deemed inappropriate or non-beneficial.

First, the high variability across hospitals, clinicians, and contexts means that it is difficult to know whether a specific surrogate-requested treatment really is contrary to "generally accepted healthcare standards" (the requisite standard to qualify for safe harbor immunity in many states).

Second, by continuing to provide treatment widely considered inappropriate (e.g. dialysis for permanently unconscious patients), clinicians are creating and reinforcing he very standard of care that they do not want to comply with.