Literature DB >> 11129843

'End-of-life' decision making within intensive care--objective, consistent, defensible?

A J Ravenscroft1, M D Bell.   

Abstract

OBJECTIVE: To determine the objectivity, consistency and professional unanimity in the initiation, continuation and withdrawal of life-prolonging procedures in intensive care--to determine methods, time-scale for withdrawal and communication with both staff and relatives--to explore any professional unease about legality, morality or professional defensibility.
DESIGN: A structured questionnaire directed at clinical nurse managers for intensive care.
SETTING: All intensive care units in the Yorkshire region.
RESULTS: The survey reported a lack of consistency and objectivity in decision making in this area, with accompanying unease amongst staff.
CONCLUSIONS: There is a need to work towards more consistent care, both before and during admission, for the protection of the individual patient and to allow rational assessment of intensive care need. Comprehensive audit should lead to objective defensible decisions and facilitate informed choice. More open debate and better communication should minimise this issue as a source of stress amongst staff in intensive care.

Entities:  

Keywords:  Death and Euthanasia; Empirical Approach

Mesh:

Year:  2000        PMID: 11129843      PMCID: PMC1733310          DOI: 10.1136/jme.26.6.435

Source DB:  PubMed          Journal:  J Med Ethics        ISSN: 0306-6800            Impact factor:   2.903


  17 in total

1.  The Riyadh Intensive Care Program applied to a mortality analysis of a teaching hospital intensive care unit.

Authors:  S Jacobs; A Arnold; P A Clyburn; B A Willis
Journal:  Anaesthesia       Date:  1992-09       Impact factor: 6.955

2.  Physician decisions regarding life support in the intensive care unit.

Authors:  M L Osborne
Journal:  Chest       Date:  1992-01       Impact factor: 9.410

3.  Attitudes of medical students, housestaff, and faculty physicians toward euthanasia and termination of life-sustaining treatment.

Authors:  P V Caralis; J S Hammond
Journal:  Crit Care Med       Date:  1992-05       Impact factor: 7.598

4.  Living wills put on statutory footing.

Authors:  C Dyer
Journal:  BMJ       Date:  1998-01-03

5.  Predicting outcome among intensive care unit patients using computerised trend analysis of daily Apache II scores corrected for organ system failure.

Authors:  R W Chang; S Jacobs; B Lee
Journal:  Intensive Care Med       Date:  1988       Impact factor: 17.440

6.  Predicting deaths among intensive care unit patients.

Authors:  R W Chang; S Jacobs; B Lee; N Pace
Journal:  Crit Care Med       Date:  1988-01       Impact factor: 7.598

7.  The physician's responsibility toward hopelessly ill patients. A second look.

Authors:  S H Wanzer; D D Federman; S J Adelstein; C K Cassel; E H Cassem; R E Cranford; E W Hook; B Lo; C G Moertel; P Safar
Journal:  N Engl J Med       Date:  1989-03-30       Impact factor: 91.245

8.  European attitudes towards ethical problems in intensive care medicine: results of an ethical questionnaire.

Authors:  J L Vincent
Journal:  Intensive Care Med       Date:  1990       Impact factor: 17.440

9.  The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults.

Authors:  W A Knaus; D P Wagner; E A Draper; J E Zimmerman; M Bergner; P G Bastos; C A Sirio; D J Murphy; T Lotring; A Damiano
Journal:  Chest       Date:  1991-12       Impact factor: 9.410

10.  Legal myths about terminating life support.

Authors:  A Meisel
Journal:  Arch Intern Med       Date:  1991-08
View more
  5 in total

Review 1.  Ethics and decision making in end stage lung disease.

Authors:  A K Simonds
Journal:  Thorax       Date:  2003-03       Impact factor: 9.139

2.  Ethical, political, and social aspects of high-technology medicine: Eos and care.

Authors:  Nereo Zamperetti; Rinaldo Bellomo; Maurizio Dan; Claudio Ronco
Journal:  Intensive Care Med       Date:  2006-04-14       Impact factor: 17.440

3.  The legal framework for end of life care: a United Kingdom perspective.

Authors:  Dominic Bell
Journal:  Intensive Care Med       Date:  2006-11-08       Impact factor: 17.440

Review 4.  Ethics review: position papers and policies--are they really helpful to front-line ICU teams?

Authors:  Laura Hawryluck
Journal:  Crit Care       Date:  2006       Impact factor: 9.097

5.  Enhancing patient safety by integrating ethical dimensions to Critical Incident Reporting Systems.

Authors:  Kai Wehkamp; Eva Kuhn; Rainer Petzina; Alena Buyx; Annette Rogge
Journal:  BMC Med Ethics       Date:  2021-03-08       Impact factor: 2.652

  5 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.