Perceptions of "futile care" among caregivers in intensive care units

Sibbald, Robert; Downar, James; Hawryluck, Laura

doi:10.1503/cmaj.070144

Cited by 113 publications

(128 citation statements)

References 57 publications

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“…Futile intensive care has been defined as "use of considerable resources without a reasonable hope that the patient would recover to a state of relative independence or be interactive with his or her environment" [1]. A more recent definition is "interventions that prolong life without achieving an effect that the patient can appreciate as a benefit" [2].…”

Section: Definition and Recognition Of Futilitymentioning

confidence: 99%

When ICU Treatment Becomes Futile

Vincent¹

2014

J Clinic Res Bioeth

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Many patients admitted to the intensive care unit (ICU) have no hope of meaningful survival and receive "futile" therapy. When a patient is no longer capable of deciding (so that autonomy is no longer applicable), giving futile treatment is against the three other key ethical principles: beneficence, non-maleficence, and distributive justice. Continuing futile treatments impacts on the patient and his/her family, but also on other patients and society as a whole. In such situations, the goal of intensive care should no longer be to maximize a patient's chances of a good quality of life on discharge but rather to provide them with a dignified and comfortable death. Once a decision has been made that intervention is futile, all on-going treatment should thus be withdrawn except for comfort measures. Good and continuing communication with the family and all members of the healthcare team is an essential aspect of insuring the best possible dying process. In this article, we will explore this complex area and try to provide answers to some of the difficult issues involved, including how futility can be recognized, who should determine that further treatment is futile, and what should be done once it has been decided that further treatment is futile in a particular patient.

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Section: Definition and Recognition Of Futilitymentioning

confidence: 99%

When ICU Treatment Becomes Futile

Vincent¹

2014

J Clinic Res Bioeth

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“…[3][4][5][6][7][8] Although defining futile treatment has been difficult and controversial, 9,10 most physicians acknowledge it as a valid concept and believe that treatments that do not fulfill the goals of medicine should not be performed. [11][12][13] Researchers in several studies 3,5,7 have reported that, compared with physicians, nurses experience more moral distress when confronted with these circumstances. In 1 survey, 3 nurses not only perceived more circumstances to be morally distressing than physicians did, but nurses also gave lower ratings for the ethical ICU environment, quality of care, and level of team collaboration than physicians did.…”

mentioning

confidence: 99%

Concordance of Nurses and Physicians on Whether Critical Care Patients are Receiving Futile Treatment

Neville¹,

Wiley²,

Yamamoto³

et al. 2015

American Journal of Critical Care

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“…Intractable conflicts about withdrawal of life support are rare, as are applications to the Consent and Capacity Board. 6 Yet futile care may be common, 7,8 and the number of referrals to the Consent and Capacity Board for withdrawal of life support has increased recently.…”

Section: Implications For Practicementioning

confidence: 99%

“…8 We focus on the implications of the Supreme Court's decision for cases in which the medical team feels that ongoing life support would be nonbeneficial, however the team arrived at that opinion. The Supreme Court's decision may trigger more referrals to the Consent and Capacity Board or may increase the incidence of nonbeneficial care, if it is interpreted to grant a right to demand treatment and physicians accede to such demands to avoid the legal system.…”

Section: Implications For Practicementioning

confidence: 99%