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Palliative medicine in the intensive care unit 

Palliative medicine in the intensive care unit
Chapter:
Palliative medicine in the intensive care unit
Author(s):

Nathan Cherny

, Sharon Einav

, and David Dahan

DOI:
10.1093/med/9780199656097.003.0157
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date: 07 May 2021

Despite best efforts, a substantial proportion of patients admitted to intensive care units die either during care or after a trial of intensive supportive therapy that fails to improve the patient’s well-being. The duality of hope and death challenges clinicians, family members of desperately ill patients, and sometimes the patients themselves. Given this high prevalence of mortality, it is incumbent upon intensive medicine units to develop the skills and therapeutic environment that can effectively deal with humane end-of-life care. This is reflected in a growing medical literature, the development of clinical standards, and in a new research agenda addressing the needs of intensive care patients, their families, and the clinicians caring for them. This chapter reviews these developments and outlines frameworks for care strategies, symptom management, and quality improvement initiatives.

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