The ten barriers to appropriate management of patients at the end of their life

Intensive Care Medicine
Ken M Hillman, Magnolia Cardona-Morrell

Abstract

The development of ICUs as the final option for seriously ill patients, especially the elderly frail patient at the end of his/her life, has meant that intensivists have increasingly taken on the role of diagnosing the dying. Our society, and even our medical colleagues, do not necessarily understand what we can achieve in ICUs, and even more importantly, what we cannot achieve. The next crucial step for us as individuals, and through our professional bodies, is to engage our society in discussions on our role and encourage debate and discussion, being aware of the controversies that will inevitably result. Birthing in the 1950s was medicalised without discussion with women and their families. In a similar manner, dying has been medicalised in the twenty-first century. It has not been a conspiracy and the use of futile and expensive treatment at the EoL transition is not necessarily anyone's choice. The specialty of intensive care has a particularly important role in facilitating discussions with our society in order to define different ways of managing dying.

References

Apr 22, 1999·The New England Journal of Medicine·J S Goodwin
Apr 16, 2002·BMJ : British Medical Journal·David Clark
Mar 23, 2004·Health Services Research·Amber E BarnatoAlan M Garber
Aug 17, 2010·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Ken Hillman
Mar 5, 2011·Intensive Care Medicine·Jacobo SellaresAntoni Torres
Oct 4, 2011·Intensive Care Medicine·Robert D Truog
Jan 10, 2012·Intensive Care Medicine·Márcio Soares, Jefferson P Piva
Apr 2, 2013·Social Science & Medicine·Betty GillBeryl Hesketh
Nov 14, 2013·JAMA : the Journal of the American Medical Association·Hamilton MosesSatoshi Yoshimura
Nov 2, 2014·The Medical Journal of Australia·Lindy WillmottDominic J C Wilkinson

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Citations

Apr 14, 2016·Intensive Care Medicine·Jason PhuaUNKNOWN Asian Critical Care Clinical Trials Group
Jun 30, 2016·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·M Cardona-MorrellK Hillman
Sep 22, 2017·Intensive Care Medicine·Crystal E BrownJ Randall Curtis
Mar 10, 2017·British Journal of Hospital Medicine·Jillian Hartin, Judy Walker
Oct 6, 2018·Internal Medicine Journal·Ian A Scott
Oct 3, 2017·PloS One·Alison E TurnbullDale M Needham
Dec 28, 2018·Journal of Clinical Nursing·Alessandro StievanoGennaro Rocco
Jun 15, 2018·Asia-Pacific Journal of Clinical Oncology·Monique BattenAlison Davis

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