Refusal of care in the intensive care: how makes decision?

Annales Françaises D'anesthèsie Et De Rèanimation
M BorelC Hervé

Abstract

Decision-making bringing to an admission or not in intensive care is complex. The aim of this study is to analyze with an ethical point of view the making decision process leading to the refusal and its consequences. It is proposed a setting in prospect through the principles of beneficence, non-maleficience, respect for autonomy, justice, and the Leonetti law. Prospective study in surgical reanimation at the University Hospital of Rouen over 9 months (November 2007-September 2008). Systematic collection for each non-admitted patient of the general characters, the methods of decision making, immediate becoming and within 48 h Constitution of two groups: patients for whom an admission in intensive care could be an unreasonable situation of obstinacy, and patients for whom an admission in reanimation would not be about unreasonable if it occurred. One hundred and fifty situations were analyzed. The potentially unreasonable character of an admission does not involve necessarily a refusal of care in intensive care. The question of the lack of place and equity in the access to the care is real but relative according to the typology of the patients. The research of the respect of the autonomy of the patient is difficult but could be ...Continue Reading

References

May 5, 1998·Intensive Care Medicine·F Lemaire, E Ferrand
Oct 31, 2001·Intensive Care Medicine·P D Levin, C L Sprung
Nov 9, 2001·Critical Care Medicine·E AzoulayUNKNOWN PROTOCETIC Group
Jul 9, 2004·Critical Care Medicine·Tasnim SinuffUNKNOWN Values Ethics and Rationing in Critical Care Task Force
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Jul 5, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Guillaume ThiéryBenoît Schlemmer
Nov 23, 2006·Annales Françaises D'anesthèsie Et De Rèanimation·A LienhartUNKNOWN Groupe de réflexion éthique de la Sfar
May 13, 2008·Annales Françaises D'anesthèsie Et De Rèanimation·M BorelC Hervé

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Citations

Feb 7, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·M BorelB Dureuil
Mar 10, 2011·Current Opinion in Anaesthesiology

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