Since its infancy in the 1980s, the concept of medical futility has represented the challenge between increasing technological advancements in medicine and how to approach their limits. Given the nature of the debate, this is likely to continue to be the case; however, in recent years, the concept of medical futility has softened as many have realized that determinations of futile care do not fall solely under the purview of medical experts. Although some jurisdictions continue to enshrine the concept of futility, many professional societies and states have begun to transition away from strong invocations of medical futility toward more robust methods of shared decision making and more equitable procedures for resolving intractable disputes. This review attempts to trace the history of medical futility from its rise in the 1980s to its fall over the past few years, to grasp medical futility as a conceptual model, and, finally, to provide a template for invoking futility in an age when most admit that patient desires are integral to understanding both the goals of care and potentially inappropriate treatments. This review contains 3 figures and 30 references Key words: end-of-life care, futile care, ineffective care, medical futility, potentially inappropriate care