Efforts to answer the question of whether or when physicians may unilaterally refuse to
provide treatments they deem medically futile, but that are nonetheless demanded by
patients or their surrogates, have been characterized as intractable failures. We propose a
new look at this old problem and suggest reframing the debate in terms of the implicit social
contract, in healthy democracies, between the medical profession and the society it serves.
This ever-evolving contract is predicated upon providing patients with beneficial and desired …