Death in the ICU: why integrate palliative care?

  • L. Scott Wilner
  • M. A. DeVita


As society increasingly demands better end-of-life care, it is incumbent upon critical care practitioners in particular to learn to manage death and dying with the same expertise they bring to other complex problems encountered in the care of critically ill patients. Patients dying — and surviving — in a critical care unit should be cared for by providers with expertise in palliative care and critical care. It is possible, but not necessary, that a single provider may be able to have both skill sets. The proposition that there is a place for palliative care in the critical care unit is not unchallenged, and is ambitious. Nevertheless, it is not unrealistic and demands further exploration. There is significant data indicating that many intensive care unit (ICU) patients’ needs are unmet by current practice patterns. There is also preliminary data indicating that integrating palliative care practice into the ICU environment is not only feasible, but results in improved outcome (though not survival). Incorporating palliative care into critical care practice will require considerable attitude change and education. The ideal methodology for educating critical care professionals and trainees in end-of-life care continues to evolve as a work in progress. We believe that there is no longer any doubt that competence in these matters — such as conducting a resuscitation, managing a ventilator, or placing vascular access — will be a requisite fundamental skill for intensivists in the future.


Intensive Care Unit Palliative Care Critical Care Intensive Care Unit Patient Critical Care Unit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia, Milano 2004

Authors and Affiliations

  • L. Scott Wilner
  • M. A. DeVita

There are no affiliations available

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