Critical Illness and End-of-Life Issues: A Global View
In the United States, we have had considerable difficulty tackling end-of-life issues in the intensive care unit (ICU). With medicine and pharmacology making more and more advances, bedside clinicians are facing questions that were not asked 20 or 30 years ago. The answers (some, but not all) are somewhat nebulous. For the most part, medical specialists seem unwilling or unable to answer or address these questions. Critical care physicians are uniquely placed to address end-of-life issues. The formula used by most critical care physicians is direct communication with the family in an atmosphere in which family members can interact with the medical team. The critical care physicians use many personnel to help them with this task, including ICU nurses and hospital clergy. It is important for the critical care team to address the family's goals for therapy.
KeywordsIntensive Care Unit Critical Care Critical Illness Critical Care Physician Intensive Care Unit Nurse
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- 3.Thiagraj Soobramoney vs. Minister of Health, Province of Kwazulu-Natal, South Africa. Durban Supreme Court Case Number 5846197, August 1997.Google Scholar
- 4.Language Use and English-Speaking Ability: 2000. Available at http://www.census.gov/prod/2003pubs/c2kbr-29.pdf. Accessed on February 9, 2006.
- 5.Pope John Paul II. The gospel of life. Available at: http://www.vatican.va/holy_father/john_paul_ii/encyclicals/documents/hf_jp-ii_enc_2503199evangelium-vitae_en.html. Accessed on February 9, 2006.
- 6.Shaw GB. Prologues. In: The doctor’s dilemma. London: Oldhams Press; 1938:280.Google Scholar
- 8.Rawls J. Political liberalism. New York: Columbia University Press; 1993:49–50.Google Scholar
- 9.Nattrass N. The moral economy of AIDS in South Africa. Cambridge: Cambridge University Press; 2004:35–40.Google Scholar
- 12.Bhagwanjee S. Audit of intensive care utilisation in Kwazulu-Natal.Google Scholar
- 13.Watters D. Intensive care in Zambia. Intensive Care World 1989;6:211–215.Google Scholar
- 14.Thiagraj Soobramoney vs. Minister of Health, Province of Kwazulu-Natal, South Africa. Durban Supreme Court Case Number 5846197, August 1997.Google Scholar
- 17.Shaw GB. Prologues. In: The doctor’s dilemma. London: Oldhams Press; 1938.Google Scholar
- 18.Dörner D. The logic of failure. New York: Basic Books; 1996:17.Google Scholar
- 20.Paris JJ, Muir JC, Reardon FE. Ethical and legal issues in intensive care. J Intensive Care Med 1977;12:298–309.Google Scholar