Health professional decision-making in the ICU: a review of the evidence.
End-of-life decisions in the ICU are often complex and emotionally charged. Intensivists can correct the physiologic abnormalities of acute and chronic illness with drugs and technology, and prolong life in many situations. Understanding and attending to the psychological and emotional needs of not only patients but also their families are part of the delivery of compassionate critical care. The process of communicating and decision-making on the ICU team and in family units has been a domain of active research over the past decade. Studies on do-not-resuscitate orders, and advanced and delayed directives comprise a portion of this work. This article contains a brief summary of selected research evidence on these difficult end-of-life issues.
Cook
D J
DJ
Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada.
D016223:Advance Directives; D003657:Decision Making; D004992:Ethics, Medical; D005066:Euthanasia, Passive; D005190:Family / Q000523:psychology; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008020:Life Support Care / Q000592:standards*; D010348:Patient Care Team / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D016414:Resuscitation Orders; D014481:United States