title: Four wishes for Aubrey.
abstract: In the critical care environment, what begins as cure-oriented and life-extending treatment may become unsuccessful in overcoming the patient's increasingly complex pathophysiology. A case from the neonatal intensive care unit is presented and used to elaborate upon care transitions toward palliative and supportive care that can be rendered in the hospital, at home or in a hospice facility. Successful transitions may rest upon anticipatory guidance by the primary physician and team, or a consultant, to facilitate and enable parents and team members alike in addressing the hard realities that cure, or even successful ICU discharge, is unlikely. A simple mechanism of addressing and accommodating a family's wishes is provided.
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA. Brian.Carter@vanderbilt.edu
authors.forename: B S
authors.initials: BS
authors.lastname: Carter
authors.forename: J B
authors.initials: JB
authors.lastname: Brown
authors.forename: S
authors.initials: S
authors.lastname: Brown
authors.forename: E C
authors.initials: EC
authors.lastname: Meyer
mesh_terms: D001601:Bereavement; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D008297:Male; D011368:Professional-Family Relations; D013727:Terminal Care / Q000379:methods*