Ethics of Futile Care: Who Decides When Enough Is Enough?—A Commentary From the Indian Context on Moral Distress in ICU Staff

This paper examines the ethical dilemmas surrounding futile care in Indian intensive care units, specifically focusing on the moral distress experienced by healthcare professionals when administering potentially non-beneficial interventions to terminally ill patients. Through analysis of recent literature, including systematic reviews and randomized controlled trials, this commentary explores the complex intersection of medical ethics, cultural values, resource allocation, and decision-making frameworks within India's unique healthcare landscape. The paper highlights the need for culturally sensitive approaches to end-of-life care, improved communication between healthcare providers and families, and institutional support systems to address moral distress among ICU staff. Additionally, it proposes policy recommendations and practical strategies to navigate these challenging ethical terrain while respecting patient dignity, family autonomy, and professional integrity in the Indian healthcare system.