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Outside of neonates, few patients ever recover from extracorporeal membrane oxygenation, and the longer it's used the less likely that recovery becomes. This isn't your typical life support, but full-on lung and heart life support. Apparently he was on it a full month before litigation even began, so there is really no hope here.

As far as a miracle from God is concerned I'll paraphrase from the pastor of the last church I attended: I don't want to impugn divine intervention, but there hasn't been a soul on earth that God hasn't called home. We pray for healing miracles because we want God to operate on our time table, not his.

Outside of neonates, few patients ever recover from extracorporeal membrane oxygenation, and the longer it's used the less likely that recovery becomes. This isn't your typical life support, but full-on lung and heart life support. Apparently he was on it a full month before litigation even began, so there is really no hope here.

No argument with what you're saying.

The issue is not the futility of the care, in my opinion. The issue is who makes that determination.

In the case of State-sponsored healthcare, the determiner is the government (remember that the doctors in question had their salaries paid by the government)...with only the courts for appeal.

In the case of commercial insurers (remember that, in that case, the doctors fees were paid by the insurer), the determiner would be the insurance company...with only the state insurance oversight board...and then the courts...for appeal.

In a truly free market system, the determiner would be the patient...or, if the patient is incapacitated, the patient's family. If they wished to continue with objectively futile care, that is their business as long as they had the capacity to do so. If they were paying the tab and the attending physician refused to provide the care, they could simply find another physician who was willing to do so. Or the patient could decide that it is not worth making his/her family destitute for care that would, at best, extend the life a little while.

As you said, in this case, it was clearly futile. However, in a third party payer type system, will they change the standard for futility when resources become more scarce? (for example, 80 year old widow needs hip replacement...sorry, granny, we deem this futile, since you'll only last a few more years anyway...better to spend our limited resources on a healthy 20 or 30 something who has decades left)(for example, care for lung cancer is no longer authorized as you shouldn't have been smoking anyway)