Eight things we would never do regarding end-of-life care in the ICU

Excerpt

As intensivists from three distinct regions of the world with different cultural backgrounds, we believe it relevant in this rapidly emerging period of healthcare to share thoughts among clinicians providing end-of-life care in the intensive care unit (ICU). Intimate encounters with patients near the end of their lives [1] form a foundational aspect of our vocation as intensivists. This article is our vision of eight top-tier concepts that should be embraced to usher in the best end-of-life care for all patients. We realize that not everyone will agree with these points and anticipate that our “eight things” will stimulate healthy discussion and debate. Furthermore, there might be caregivers throughout the world dealing with different cultural, legal, political, and ethical preconditions that make implementation of the approach presented within this manuscript difficult in some respects. The joint American Thoracic Society (ATS)/American Association for Critical Care Nurses (AACN)/American College of Chest Physicians (ACCP)/European Society for Intensive Care Medicine (ESICM)/Society of Critical Care (SCCM) policy statement [2] and a complementary publication [3] on responding to potentially inappropriate treatment requests provide very helpful references for us in such difficult situations as well as a seven-step procedure for resolution of conflict. …