title: Challenges in end-of-life decisions in the intensive care unit: an ethical perspective.
abstract: When making end-of-life decisions in intensive care units (ICUs), different staff groups have different roles in the decision-making process and may not always assess the situation in the same way. The aim of this study was to examine the challenges Danish nurses, intensivists, and primary physicians experience with end-of-life decisions in ICUs and how these challenges affect the decision-making process. Interviews with nurses, intensivists, and primary physicians were conducted, and data is discussed from an ethical perspective. All three groups found that the main challenges were associated with interdisciplinary collaboration and future perspectives for the patient. Most of these challenges were connected with ethical issues. The challenges included different assessments of treatment potential, changes and postponements of withholding and withdrawing therapy orders, how and when to identify patients' wishes, and suffering caused by the treatment. To improve end-of-life decision-making in the ICU, these challenges need to be addressed by interdisciplinary teams.
authors.affiliation: Department of Anaesthesiology, Vejle Hospital, Kabbeltoft 25, 7100 Vejle, Denmark. hanne.irene.jensen@slb.regionsyddanmark.dk
authors.forename: Hanne Irene
authors.initials: HI
authors.lastname: Jensen
authors.forename: Jette
authors.initials: J
authors.lastname: Ammentorp
authors.forename: Helle
authors.initials: H
authors.lastname: Johannessen
authors.forename: Helle
authors.initials: H
authors.lastname: Ørding
mesh_terms: D000328:Adult; D003657:Decision Making / Q000941:ethics*; D003718:Denmark; D005260:Female; D017144:Focus Groups; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010348:Patient Care Team; D057184:Practice Patterns, Nurses'; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D013727:Terminal Care / Q000941:ethics*; D028761:Withholding Treatment / Q000941:ethics*