Disputing Death: Medical Futility Laws and Procedures to Facilitate End of Life Discussions Among Patients, Family, and Practitioners

In a world of continuous innovation, medical care in particular has changed the way humans experience life and death—lengthening life and slowing death. But where patients have the opportunity to be kept alive with medical intervention, physicians often struggle ethically with administering care that is ultimately futile or medically inappropriate. Many times patients themselves are unable to communicate, incapacitated by their ailment. As a result, surrogates must step in to make decisions on patients’ behalves. Surrogates, acting as advocates for patients, tend to withhold consent when a provider believes continued intervention is futile and wishes to withdraw or withhold treatment. Physicians acting under bioethical principles find it difficult to continue administering treatment in these situations while exercising professional integrity, but legally have no backing to withdraw. The ability to dispute death imposes unclear and unnecessary obligations on physicians, and the need for ethical reform is imminent. South Dakota law does not currently provide guidance in these situations, but enacting a medical futility policy would stabilize this critical area of health care. This article explores medical futility disputes and strategizes how new policy can aid in navigating conflicts.