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Ethical decision making in withdrawing and withholding treatment 

Ethical decision making in withdrawing and withholding treatment
Ethical decision making in withdrawing and withholding treatment

Margaret Isaac

and Jared Randall Curtis

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date: 19 February 2020

Many patients in the USA and across the world die after having received care in an intensive care unit (ICU). Allocating resources equitably and honouring the wishes of patients and their families are essential components of intensive care. Physician and patient preferences regarding end-of-life care and regarding decision control vary by individual, region, and country, shaped and influenced by a variety of factors including cultural and religious beliefs. Surrogate decision-makers are widely called upon to perform a difficult task—to help make decisions when patients lack capacity or the ability to communicate their preferences. Communication between clinicians and families in the ICU can be enhanced by using a variety of techniques. Advance directives can help guide surrogate decision-makers and physicians. Additionally, discussions of cardiopulmonary resuscitation preferences can be improved by explicit discussions of prognosis, which can help patients and surrogate decision-makers more accurately understand the potential risks and benefits of their decisions.

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