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Importance of end of life discussions and palliative care in the Intensive Care Unit-skills for shared decision making Eiji HIRAOKA 1 1Department of Internal Medicine Tokyo Bay Urayasu Ichikawa Medical Center pp.646-656
Published Date 2020/10/1
DOI https://doi.org/10.11477/mf.3102200800
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Intensivists are required to have knowledge and skills to save and prolong the lives of patients in critical condition as well as those needing palliative care. A significant number of patients die in the intensive care unit (ICU). Even after discharge from the ICU, some suffer from chronic critical illnesses with poor quality of life (QOL). The poor QOL might not be acceptable for some patients and they might wish to discontinue life-prolonging treatment and focus on palliation. Palliative care requires a holistic approach, which includes pain management, coordination of care and end of life discussions. Intensivists frequently are not sure of the prognosis when encountering a patient in critical condition. In this situation, a time limited trial should be offered. Simultaneously, they need to discuss end of life issues, including advanced care planning, goals of care, unacceptable burden and suffering, and advance directives. Whether the patients' life can be saved or cannot be saved, palliative care and support with difficult decision-making is crucial.


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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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