Futility and Shared Decision-Making

Balancing effective medical treatment with a patient's goals of care has become increasingly complex as advanced medical technology offers a still incomplete ability to improve health in a way that the patient may or may not be able to appreciate. We can neither maintain a physician directed decision-making strategy nor offer patients a menu of options and expect them to understand the consequences of their medical decisions. Developing a robust patient-physician partnership committed to communi-cation that elicits values and goals of care is a necessary part of practicing standard -of-care medicine. The challenge moving forward will be how to create the space and time to execute this process and offer adequate sources of information to optimize pa-tient engagement.