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Sabr and Shukr: doing justice to medical futility
  1. Sara Riaz1,2
  1. 1 Department of Family Medicine, McGill University, Montreal, Québec, Canada
  2. 2 Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA
  1. Correspondence to Sara Riaz, Department of Family Medicine, McGill University, Montreal, Québec H3S 1Z1, Canada; sara.riaz{at}

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Medicine is no stranger to patience. In fact, the word ‘patient’ has an etymology stemming from the Latin word ‘patiens’, describing the one who tolerates suffering.1 In this sense, the cornerstone of medicine, the patient–physician relationship, reflects passive language, ‘to suffer’. This suffering must be understood, and should be most intimately understood by those who provide care that is beyond a patient’s reach. The case of patients and their loved ones requesting medically futile care at the end of life is one where further treatment is replaced by patience and, more rarely, the patience of medical teams is replaced by futile treatment. At the heart of this debate is not only the denial of futile care but also the need for understanding the extent of patience that must be endured as a result of it. Burns and Truog2 remark on this ethical dilemma:

The best solution – although perhaps also the most difficult – is…tolerating the demands for care that we believe to be futile, and finding ways to better support the emotional needs of each other in those rare cases where we are called on to provide this care.

The concept of futility in care represents medical intervention with limited, or no, chance of resulting in what is regarded as a clinically successful outcome. Since the American Medical Association’s endorsement of the lack of consensus on futile care in 1999, this integral conflict remains.3 This is a conflict of understanding. I believe this understanding can be strengthened by acknowledging the Arabic word for patience, ‘sabr’, along …

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  • Contributors The author has solely contributed to the conception, writing and revision of this paper.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.