- Physicians are obligated to fully communicate with patients and surrogates about diagnoses, prognoses, treatment options and risks in a timely manner to allow for informed medical decision making. However, studies show physicians often fail to discuss end of life care preferences with patients. - Determinations of medical futility can be difficult due to uncertainties in prognosis and a lack of understanding of patient values. Physicians are encouraged to have open discussions with patients and surrogates about medical futility and end of life options. - If a surrogate cannot understand the patient's medical situation or make decisions that reflect the patient's wishes, the physician may need to seek a new surrogate or consider the patient's best interests in

1. Approaches to Issues of Futility Bernard W. Freedman, JD, MPH [email_address]