Investigating the Causes of Futile Care and Cure from the Point of View of Physician and Nurses of Neurology and Neurosurgery Departments of Hospitals Affiliated to Tehran University of Medical Sciences, 2018-2019

Background &

Futile or fruitless life-saving interventions are in conflict with the four principles of medical ethics, which are not only ineffective for the patients, but also have a high burden on society. Therefore, this study aimed to determine the causes of unsuccessful life-saving treatment and interventions from the point of view of care providers in the neurology and neurosurgery departments of Tehran University of Medical Sciences hospitals.

The present study is a descriptive cross-sectional study that was conducted on 64 doctors and 72 nurses working in hospitals affiliated to the Tehran University of Medical Sciences in 2018. A 25-item researcher-made questionnaire was used to collect data. SPSS-24 software and descriptive statistics tests were used to analyze data.

The average age of doctors and nurses was 34.25±5.1 and 35.12±8.2 years, respectively. From the point of view of physicians and nurses, the most important reason for the ineffective provision of life-saving services was the lack of legal, moral and Islamic permission and guidelines to cut off life support devices and the lack of resuscitation in patients facing death (end stages of life).

The results of this study showed that, from the point of view of nurses, the most common reasons for providing futile care and cure are the moral and humane obligation of the treatment and care team to provide ineffective life-saving interventions, and from the point of view of the physician, the lack of legal, ethical and religious permission and instructions to cut off life support devices in patients has resulted in death. Some of the causes of unnecessary care were presented in this study, and some of these causes cannot be solved without solving theoretical problems and practical expert studies. Developing guidelines to define futile treatment, especially in end-of-life care, and providing solutions to control and manage treatment and unsuccessful life-saving interventions seems necessary.