title: The costs of nonbeneficial treatment in the intensive care setting.
abstract: Ethics consultations have been shown to reduce the use of "nonbeneficial treatments," defined as life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, when treatment conflicts occurred in the adult intensive care unit (ICU). In this paper we estimated the costs of nonbeneficial treatment using the results from a randomized trial of ethics consultations. We found that ethics consultations were associated with reductions in hospital days and treatment costs among patients who did not survive to hospital discharge. We conclude that consultations resolved conflicts that would have inappropriately prolonged nonbeneficial or unwanted treatments in the ICU instead of focusing on more appropriate comfort care.
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, USA. tgilmer@ucsd.edu
authors.forename: Todd
authors.initials: T
authors.lastname: Gilmer
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Schneiderman
authors.forename: Holly
authors.initials: H
authors.lastname: Teetzel
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Blustein
authors.forename: Kathleen
authors.initials: K
authors.lastname: Briggs
authors.forename: Felicia
authors.initials: F
authors.lastname: Cohn
authors.forename: Ronald
authors.initials: R
authors.lastname: Cranford
authors.forename: Daniel
authors.initials: D
authors.lastname: Dugan
authors.forename: Glen
authors.initials: G
authors.lastname: Kamatsu
authors.forename: Ernlé
authors.initials: E
authors.lastname: Young
mesh_terms: D000328:Adult; D003422:Critical Care / Q000191:economics* / Q000941:ethics / Q000706:statistics & numerical data; D003657:Decision Making; D034462:Dissent and Disputes; D033061:Ethics Consultation / Q000706:statistics & numerical data*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000941:ethics; D007902:Length of Stay; D008020:Life Support Care / Q000191:economics* / Q000941:ethics / Q000706:statistics & numerical data; D008297:Male; D018447:Medical Futility; D008875:Middle Aged; D010351:Patient Discharge; D016019:Survival Analysis; D014481:United States