Medical interventions at the end of life: what is appropriate and who is responsible?

Palliative care and euthanasia: A Nepalese scenario

Palliative care, namely the relief of pain, is a priority for cases of incurable diseases in Nepal. However, since oral morphine is not available, pain control is often inadequate. Euthanasia is not permissible by law but could be a better solution in some cases and should be made understandable to patients and physicians as in developed countries. Should euthanasia be legal? If cheap and effective palliative care were easily accessible, most terminally ill Nepalese would avoid pressure to practise euthanasia because it is a cheaper option.

Ten common questions (and their answers) on medical futility

The term medical futility is frequently used when discussing complex clinical scenarios and throughout the medical, legal, and ethics literature. However, we propose that health care professionals and others often use this term inaccurately and imprecisely, without fully appreciating the powerful, often visceral, response that the term can evoke. This article introduces and answers 10 common questions regarding medical futility in an effort to define, clarify, and explore the implications of the term. We discuss multiple domains related to futility, including the biological, ethical, legal, societal, and financial considerations that have a bearing on definitions and actions. Finally, we encourage empathetic communication among clinicians, patients, and families and emphasize how dialogue that seeks an understanding of multiple points of view is critically important in preventing or attenuating conflict among the involved parties.