Dealing with Difficult Surrogates

Erring on the Side of Autonomy

It is difficult to count the number of times house staff have paged me frantically to say that a moribund patient's family continues to desire “everything done” despite pleas for comfort measures. This situation usually occurs at three in the morning and frequently involves an elderly patient who has been transferred from a skilled nursing facility to the hospital for recurring decompensations. There is rarely evidence in the chart of any discussion regarding end-of-life care. A phone call to the relatives of the patient invariably yields the reply, “We want everything done.”


Intensive Care Unit Healthcare Provider Communication Skill American Thoracic Society Skilled Nursing Facility 
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