Palliative Care in the Surgical Intensive Care Unit

Chapter

Abstract

Patients with critical illness or injury deserve excellent symptom management, psychosocial support, and expert guidance in decision-making. Palliative care addresses the needs of patients and families at all stages of serious illness, including at the end of life or alongside life-prolonging treatments. All physicians should be comfortable providing primary palliative care to critically ill patients and engaging in shared decision-making. Surgeons can use structured communication tools to conduct patient-centered goals of care discussions and to facilitate provision of treatment recommendations that align with patient values. Specialized palliative care teams can support surgical teams in delivering high-quality care by addressing potentially unfamiliar issues such as existential suffering, spiritual unrest, and challenging family dynamics. Surgeons have a responsibility to prioritize patient autonomy within the context of serious illness and to ensure avoidance of unwanted burdensome treatments at the end of life.

Keywords

Palliative care Shared decision-making Frailty End of life Goals of care 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of WashingtonSeattleUSA
  2. 2.Department of Trauma, Burn, and Surgical Critical CareBrigham and Women’s HospitalBostonUSA

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