Are doctors supposed to be doing this? -- Why it is hard to say no -- Why we must say no -- Families who say, "do everything!" -- Futility and rationing -- Medical futility in a litigious society -- Ethical implications of medical futility -- The way it is now/the way it ought to be : for patients -- The way it is now/the way it ought to be : for health professionals -- The high points : medical futility -- Medical futility : where do we stand now?