One scenario: each doctor, each verdict. How do anesthetists identify futile therapy? A questionnaire study

Background: The amendment to the Medical Ethics Code (KEL, Kodeks Etyki Lekarskiej ), effective from 2025, introduces a new definition of futile therapy and prohibits its application. This study aimed to explore the opinions of anesthesiologists and intensivists on identifying futile therapy in clinical practice. Participants and methods: In the first quarter of 2024, an online survey was conducted among 113 physicians. Of these, 51 met the inclusion criteria: they spent more than 33% of their working time in intensive care units (ICUs) with at least six beds and implemented a protocol to prevent futile therapy. Participants were presented with five anonymized, real clinical scenarios and were asked to assess whether a proposed intervention in each case constituted futile therapy. Results: The responses — “yes,” “no,” or “I don’t know” — varied widely across cases, and no scenario reached a clear majority consensus. Conclusions: The findings reveal significant ambiguity and subjectivity in recognizing futile therapy, even among experienced ICU physicians. The frequent selection of “I don’t know” reflects the diagnostic and ethical challenges inherent in such decisions, emphasizing the importance of a consultative approach in line with ethical recommendations.