Communication in intensive care settings: the challenge of futility disputes.
In intensive care settings, suboptimal communication can erode family trust and fuel so-called "futility" disputes. Presenting a teaching case used by >225 hospitals participating in the Decisions Near the End-of-Life program, we identify critical communication challenges and opportunities. We emphasize that good communication requires not only clear and sensitive language but also clinician self-awareness, psychological insight, and an institutional culture that promotes good communication with families. The article concludes with two examples of steps institutions can take to foster good communication between families and healthcare professionals.
New York Presbyterian Hospital and Weill Medical College of Cornell University, New York, NY, USA.
J J
JJ
Fins
M Z
MZ
Solomon
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003142:Communication; D003220:Conflict, Psychological; D003422:Critical Care / Q000523:psychology*; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006282:Health Personnel / Q000193:education / Q000523:psychology; D006801:Humans; D007258:Informed Consent; D018447:Medical Futility; D015279:Organizational Culture; D010348:Patient Care Team; D011368:Professional-Family Relations; D011379:Prognosis; D011788:Quality of Life; D012944:Social Support; D013663:Teaching / Q000379:methods; D017749:Total Quality Management; D014342:Truth Disclosure