title: Ethical issues and palliative care in the cardiovascular intensive care unit.
abstract: Medical advances over the past 50 years have helped countless patients with advanced cardiac disease or who are critically ill in the intensive care unit (ICU), but have added to the ethical complexity of the care provided by clinicians, particularly at the end of life. Palliative care has the primary aim of improving symptom burden, quality of life, and the congruence of the medical plan with a patient's goals of care. This article explores ethical issues encountered in the cardiac ICU, discusses key analyses of these issues, and addresses how palliative care might assist medical teams in approaching these challenges.
authors.affiliation: Section of Palliative Medicine, Division of General Internal Medicine, Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA; Program in Professionalism and Ethics, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: swetz.keith@mayo.edu.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Swetz
authors.forename: J Keith
authors.initials: JK
authors.lastname: Mansel
mesh_terms: D032722:Advance Care Planning / Q000941:ethics; D003142:Communication; D003325:Coronary Care Units / Q000941:ethics / Q000458:organization & administration; D003422:Critical Care / Q000941:ethics*; D004992:Ethics, Medical; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices / Q000941:ethics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D018447:Medical Futility / Q000941:ethics; D010138:Pacemaker, Artificial / Q000941:ethics; D010166:Palliative Care / Q000941:ethics* / Q000458:organization & administration; D010358:Patient Participation / Q000379:methods; D011368:Professional-Family Relations; D016079:Refusal to Treat; D012121:Respiration, Artificial / Q000941:ethics; D012944:Social Support; D029181:Spirituality; D019452:Terminally Ill
chemical_list: D006993:Hypnotics and Sedatives
keywords: Advanced heart failure; Bioethics; End of life; Medical ethics; Medical technology; Palliative care