• Journal of medical ethics · Dec 2000

    'End-of-life' decision making within intensive care--objective, consistent, defensible?

    • A J Ravenscroft and M D Bell.
    • General Infirmary at Leeds, Department of Anaesthesia and Intensive Care, Great George Street, Leeds, LS1 3EX.
    • J Med Ethics. 2000 Dec 1;26(6):435-40.

    ObjectiveTo determine the objectivity, consistency and professional unanimity in the initiation, continuation and withdrawal of life-prolonging procedures in intensive care--to determine methods, time-scale for withdrawal and communication with both staff and relatives--to explore any professional unease about legality, morality or professional defensibility.DesignA structured questionnaire directed at clinical nurse managers for intensive care.SettingAll intensive care units in the Yorkshire region.ResultsThe survey reported a lack of consistency and objectivity in decision making in this area, with accompanying unease amongst staff.ConclusionsThere is a need to work towards more consistent care, both before and during admission, for the protection of the individual patient and to allow rational assessment of intensive care need. Comprehensive audit should lead to objective defensible decisions and facilitate informed choice. More open debate and better communication should minimise this issue as a source of stress amongst staff in intensive care.

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