• D Schwarzkopf.
• Klinik für Anästhesiologie und Intensivmedizin, Center for Sepsis Control and Care, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland. daniel.schwarzkopf@med.uni-jena.de.
• Med Klin Intensivmed Notfmed. 2019 Apr 1; 114 (3): 222-228.

BackgroundEthically demanding decisions in intensive care as well as the perception of nonbeneficial care can be a burden for clinicians and patients' relatives.ObjectivesAn overview of prevalence, causes, and consequences of perceived nonbeneficial care and possible interventions is provided.Materials And MethodsNarrative review.Results And ConclusionsThe perception of nonbeneficial care is a subjective moral judgement. Almost every ICU clinician regularly perceives nonbeneficial care. There is clear evidence that perceived nonbeneficial care is associated with burnout of clinicians and intention to leave the job. For relatives being involved in end-of-life decisions is of particular burden. Clinicians often state that relatives' whishes are the reason for nonbeneficial life-sustaining treatment. A good ethical climate as well as good nurse-physician collaboration are associated with less perception of nonbeneficial care and shorter time to therapy limitations. Structured communication to plan therapy involving relatives might reduce nonbeneficial care and together with supporting interventions reduce staff burnout. Improving communication by consultants in charge has been shown to reduce the burden of relatives. In future, co-treating surgeons must be more strongly involved in interventions.

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