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                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, February 11, 1993                   TAG: 9302110322
SECTION: EDITORIAL                    PAGE: A-14   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Short

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PUBLIC NEEDS TO UNDERSTAND `FUTILE CARE'

I READ with interest Ellen Goodman's column, "Doing too much to the dying," and Jane Brody's column, "Uncertainty, confusion hamper the rights of a dying patient," in the Feb. 2 issue of the Roanoke Times & World-News.

Futile care (medical therapy rendered with minimal chance of meaningful survival) ranks among the top three causes of spiraling health-care costs. A significant part of upcoming health-care reform must be devoted to educating the public and health-care providers about futile care. These educational efforts began long ago within the field of medicine. Critical-illness survival scales, medical-ethics education and living wills have all been efforts by the medical profession to help recognize and deal with futile care. Generally speaking, physicians and critical-care nurses do recognize futile care, and we can be fair and objective in determining when patients have less than a 10 percent chance of surviving their illness.

Unfortunately, many times providers are unable to halt futile care, because families refuse to quit despite being appraised by the facts with recommendations to "let nature take its course." Physicians are reluctant to go against the wishes of a family in this setting for empathetic as well as medical and legal reasons.

I applaud your coverage of this sensitive and important issue in health care, as education of the public must coincide with education of health-care providers for the problem of futile care to be remedied. F. JACKSON BALLENGER, M.D. President Roanoke Valley Academy of Medicine ROANOKE

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