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Palliative and end-of-life care in the ICU 

Palliative and end-of-life care in the ICU
Chapter:
Palliative and end-of-life care in the ICU
Author(s):

Phillip D. Levin

, and Charles L. Sprung

DOI:
10.1093/med/9780198746690.003.0393
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date: 02 March 2021

What happens when organ support leads to prolongation of life, but with no hope of ultimate survival, or survival with unacceptable quality of life? For many—but not all—patients, families, and physicians, prolongation of life with little or no hope of a good quality of life is considered worse than death. This chapter looks at the cultural milieu in determining the responses and needs of all parties in regard to end-of-life care. Excellent communication is required to prevent potential conflicts and provide both the medical team and the patient/family with peace of mind. The decision to institute palliative or end-of-life care should, if at all possible, always be reached via a negotiating process between the medical staff and the patient or their family. The best protection against conflict comes from a good bedside manner reflecting patience with the family, honesty, and some optimism.

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