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Erschienen in: Critical Care 4/2005

01.08.2005 | Commentary

Medical treatment for the terminally ill: the 'risk of unacceptable badness'

verfasst von: David Crippen

Erschienen in: Critical Care | Ausgabe 4/2005

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Abstract

When patients or their families rarely request inappropriate end of life care in the ICU for capricious reasons. End of life treatment decisions that only prolong discomfort and death are usually emotional and based on unrealistic expectations. I explore some of those reasons in this paper.
Literatur
1.
Zurück zum Zitat Silverman HJ: Withdrawal of feeding-tubes from incompetent patients: the Terri Schiavo case raises new issues regarding who decides in end-of-life decision making. Intensive Care Med 2005, 31: 480-481. 10.1007/s00134-004-2542-8CrossRefPubMed Silverman HJ: Withdrawal of feeding-tubes from incompetent patients: the Terri Schiavo case raises new issues regarding who decides in end-of-life decision making. Intensive Care Med 2005, 31: 480-481. 10.1007/s00134-004-2542-8CrossRefPubMed
2.
Zurück zum Zitat Afessa B, Keegan MT, Mohammad Z, Finkielman JD, Peters SG: Identifying potentially ineffective care in the sickest critically ill patients on the third ICU day. Chest 2004, 126: 1905-1909. 10.1378/chest.126.6.1905CrossRefPubMed Afessa B, Keegan MT, Mohammad Z, Finkielman JD, Peters SG: Identifying potentially ineffective care in the sickest critically ill patients on the third ICU day. Chest 2004, 126: 1905-1909. 10.1378/chest.126.6.1905CrossRefPubMed
3.
Zurück zum Zitat Powner DJ, Bernstein IM: Extended somatic support for pregnant women after brain death. Crit Care Med 2003, 31: 1241-1249. 10.1097/01.CCM.0000059643.45027.96CrossRefPubMed Powner DJ, Bernstein IM: Extended somatic support for pregnant women after brain death. Crit Care Med 2003, 31: 1241-1249. 10.1097/01.CCM.0000059643.45027.96CrossRefPubMed
4.
Zurück zum Zitat Khalafi K, Ravakhah K, West BC: Avoiding the futility of resuscitation. Resuscitation 2001, 50: 161-166. 10.1016/S0300-9572(01)00332-XCrossRefPubMed Khalafi K, Ravakhah K, West BC: Avoiding the futility of resuscitation. Resuscitation 2001, 50: 161-166. 10.1016/S0300-9572(01)00332-XCrossRefPubMed
5.
Zurück zum Zitat Crippen D: Terminally weaning awake patients from life sustaining mechanical ventilation:the critical care physician's role in comfortmeasures during the dying process. Clin Intensive Care 1992, 3: 206-212. Crippen D: Terminally weaning awake patients from life sustaining mechanical ventilation:the critical care physician's role in comfortmeasures during the dying process. Clin Intensive Care 1992, 3: 206-212.
6.
Zurück zum Zitat Luce JM, Alpers A: End-of-life care: what do the American courts say? Crit Care Med 2001, (Suppl):N40-N45. 10.1097/00003246-200102001-00008 Luce JM, Alpers A: End-of-life care: what do the American courts say? Crit Care Med 2001, (Suppl):N40-N45. 10.1097/00003246-200102001-00008
7.
Zurück zum Zitat Arnold RM, Kellum J: Justifications for surrogate decision making in the intensive care unit: implications and limitations. Crit Care Med 2003, (Suppl):S347-S353. 10.1097/01.CCM.0000065123.23736.12 Arnold RM, Kellum J: Justifications for surrogate decision making in the intensive care unit: implications and limitations. Crit Care Med 2003, (Suppl):S347-S353. 10.1097/01.CCM.0000065123.23736.12
8.
Zurück zum Zitat Goold SD, Williams B, Arnold RM: Conflicts regarding decisions to limit treatment: a differential diagnosis. JAMA 2000, 283: 909-914. 10.1001/jama.283.7.909CrossRefPubMed Goold SD, Williams B, Arnold RM: Conflicts regarding decisions to limit treatment: a differential diagnosis. JAMA 2000, 283: 909-914. 10.1001/jama.283.7.909CrossRefPubMed
9.
Zurück zum Zitat Whetstine L: When is 'dead' dead: an examination of the medical and philosophical literature on the determination of death. In Dissertation. Pittsburgh, PA: Duquesne University; 2004. Whetstine L: When is 'dead' dead: an examination of the medical and philosophical literature on the determination of death. In Dissertation. Pittsburgh, PA: Duquesne University; 2004.
10.
Zurück zum Zitat Crippen D, Levy M, Whetstine L, Kuce J: Debate: What constitutes 'terminality'and how does itrelate to a living will? Crit Care 2000, 4: 333-338. 10.1186/cc717PubMedCentralCrossRefPubMed Crippen D, Levy M, Whetstine L, Kuce J: Debate: What constitutes 'terminality'and how does itrelate to a living will? Crit Care 2000, 4: 333-338. 10.1186/cc717PubMedCentralCrossRefPubMed
11.
Zurück zum Zitat Lynn J, Teno JM, Phillips RS, Wu AW, Desbiens N, Harrold J, Claessens MT, Wenger N, Kreling B, Connors AF Jr: Perceptions by family members of the dying experience of older and seriously ill patients. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Ann Intern Med 1997, 126: 97-106.CrossRefPubMed Lynn J, Teno JM, Phillips RS, Wu AW, Desbiens N, Harrold J, Claessens MT, Wenger N, Kreling B, Connors AF Jr: Perceptions by family members of the dying experience of older and seriously ill patients. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Ann Intern Med 1997, 126: 97-106.CrossRefPubMed
13.
Zurück zum Zitat Frick S, Uehlinger DE, Zuercher Zenklusen RM: Medical futility: predicting outcome of intensive care unit patients by nurses and doctors – a prospective comparative study. Crit Care Med 2003, 31: 456-461. 10.1097/01.CCM.0000049945.69373.7CCrossRefPubMed Frick S, Uehlinger DE, Zuercher Zenklusen RM: Medical futility: predicting outcome of intensive care unit patients by nurses and doctors – a prospective comparative study. Crit Care Med 2003, 31: 456-461. 10.1097/01.CCM.0000049945.69373.7CCrossRefPubMed
14.
Zurück zum Zitat Kelly D: Medical futility in American health care. In Three Patients: End of Life Care in Intensive Care Medicine. Edited by: Crippen D, Kilkullen J, Kelly D. New York: Kluwer Publishers; 2002:7-23.CrossRef Kelly D: Medical futility in American health care. In Three Patients: End of Life Care in Intensive Care Medicine. Edited by: Crippen D, Kilkullen J, Kelly D. New York: Kluwer Publishers; 2002:7-23.CrossRef
15.
Zurück zum Zitat Cassell J, Buchman TG, Streat S, Stewart RM, Buchman TG: Surgeons, intensivists, and the covenant of care: administrative models and values affecting care at the end of life. Crit Care Med 2003, 31: 1263-1270. 10.1097/01.CCM.0000059318.96393.14CrossRefPubMed Cassell J, Buchman TG, Streat S, Stewart RM, Buchman TG: Surgeons, intensivists, and the covenant of care: administrative models and values affecting care at the end of life. Crit Care Med 2003, 31: 1263-1270. 10.1097/01.CCM.0000059318.96393.14CrossRefPubMed
Metadaten
Titel
Medical treatment for the terminally ill: the 'risk of unacceptable badness'
verfasst von
David Crippen
Publikationsdatum
01.08.2005
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 4/2005
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc3715

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