%0 Journal Article
%T Between Life Prolongation and Meaning Preservation: A Heideggerian–Gadamerian Perspective on Medical Futility
%A Ling Lang Huang
%J Asian Journal of Ethics in Health and Medicine
%@ 3108-5059
%D 2023
%V 3
%N 1
%R 10.51847/gOTiY38VSQ
%P 350-360
%X In cases of medically futile care, clinical choices frequently turn into deeply complex ethical and existential dilemmas. Physicians and patients must navigate the difficult balance between extending life and maintaining its meaningful quality. Traditional shared decision-making (SDM) models primarily focus on evidence-based rationality but often fail to address the deeper ontological aspects of patients’ lived realities. The present study employs interpretative phenomenological analysis (IPA) to explore the personal narratives and value systems of Ms. M and her three attending physicians. Guided by Heidegger’s idea of being-in-the-world and Gadamer’s concept of the fusion of horizons, we conducted an interpretative phenomenological analysis (IPA) based on extensive interviews with one terminal cervical cancer patient and her three treating physicians (experts in cardiology, cardiac surgery, and gynecologic oncology). These philosophical lenses informed both our analytical framework and the ethical evaluation of SDM practices when medical interventions offer no realistic benefit. The findings demonstrate that pursuing aggressive therapies despite clear medical futility cannot be dismissed as mere irrational behavior. Such decisions instead stem from fundamentally different value systems and understandings of time between patients and physicians. Even a clinically appropriate choice may fall short ethically if it disregards the patient’s personal lived horizon. We introduce a hermeneutic approach to SDM that builds on the standard evidence-based model by incorporating three key elements: deep attunement to the patient’s existential reality, genuine fusion of horizons between the patient and the physician, and acceptance of irreducible differences. This framework enables ethically robust decisions while respecting both clinical expertise and the patient’s fundamental way of being-in-the-world.  
%U https://smerpub.com/article/between-life-prolongation-and-meaning-preservation-a-heideggeriangadamerian-perspective-on-medical-x9l5tebgjccgx2q