How should clinicians respond to requests for potentially inappropriate treatment?
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One of the most ethically controversial issues in intensive care units (ICUs) is how to respond to requests from surrogates to administer life-prolonging interventions when clinicians believe those interventions should not be administered. This article will outline the framework provided by a new multi-society consensus statement regarding such requests.
Several recent studies suggest that disputed requests for treatment in ICUs in North America and Europe are common. One survey of European ICUs demonstrated that 27 % of practitioners believed they provided inappropriate care to a patient on the day of the study . Recently, a single-center study demonstrated that up to 20 % of ICU patients were perceived by physicians as receiving at least “probably futile” treatment . While there is considerable methodological heterogeneity among these studies, it appears that conflicts regarding treatment requests in ICUs are not infrequent.
Previous guidelines from professional...
KeywordsInappropriate Treatment Fair Process Futile Intervention Discretionary Treatment Societal Consensus
Compliance with ethical standards
Conflicts of interest
The authors have no conflicts of interest related to this work.
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