Families and withdrawal of life-sustaining therapy: state of the science.

As the science progresses related to families participating in the process of withdrawal of life-sustaining therapy (LST), it is important to assess research accomplishments, identify gaps in the knowledge and ways to build on the science, and suggest new directions for future research. Research-based articles related to families participating in the process of withdrawal of LST were obtained by conducting computer-assisted searches and analyzing references lists. A grid was developed that included key variables from each of the studies. A second grid was developed and included the subthemes that evolved from the analysis. Eleven studies were reviewed and analyzed. Themes that evolved include illness context, family context, and family and health care provider interactions. Important information has been discovered about the family decision-making process and helpful health care provider interactions. Additional research focused on withdrawal of LST is needed to understand important concepts, develop instruments, and test interventions.