Schneiderman, Teetzel, and Gilmer offer an amusing but misleading response to my article on medical futility (CQ Vol 11, No 2). Although I did make note of the falloff in citations to medical futility in Medline and Bioethicsline after 1995, my analysis focused on the precipitous rise in professional publications on the concept in the period from 1988 to 1995—a trend confirmed by the authors' own search results. I certainly did not argue, either explicitly or implicitly, that the discussion of medical futility was over. I made limited use of this citation survey—to raise a question about what sparked so much professional debate after 1988. This seems to me an entirely appropriate methodology.

I also wish to correct a false impression created by this response. The authors suggest that the search they carried out on medical futility showed that citations have plateaued. They argue that I missed this trend because I used an out-of-date search engine (Medline and Bioethicsline rather than PubMed) and because I arbitrarily cut off the time frame (at 1998). As to the first charge, I would think that the 4,500 medical journals included in Medline provide an adequate database for the modest purpose I had in mind. Regarding the time frame, the authors might be more sympathetic if they knew that the article was accepted for publication in 2000, even though it did not appear until 2002. In any case, given that I concentrated my comments on the 1988–1995 period, it is peculiar that the authors should focus their criticisms on subsequent developments.

Finally, the authors' sarcastic suggestion that I sought to make medical futility “disappear” by manipulating a citation search is directly contradicted by the thrust of the article, which underscores the continuing importance of ethical and clinical discussions about the concept. Would that they had commented on what I actually did argue.