• Warwick W Butt.
• Intensive Care Unit, Royal Childrens Hospital, Melbourne, Australia.
• Pediatr Crit Care Me. 2018 Aug 1; 19 (8S Suppl 2): S57-S58.

ObjectiveTo describe individual perspective over ~30 years in a mixed Cardiac and General ICU, which includes the State Trauma Center, National Cardiac Transplant and Complex Cardiac Center, Extracorporeal Membrane Oxygenation Center, Home Ventilation Program, and the major PICU for 6 million people.Data SourcesPersonal experience and reflection, complemented by published local data.Study SelectionIllustrative publications of local other data.Data SynthesisNarrative, experiential reflection.ConclusionsI have agreed to palliative care in many patients of diverse religious, social, and cultural beliefs while providing long-term ICU care to other patients with similar illnesses and prognosis. This can occur when family meetings allow honest and direct conversation with respect for differences; as a clinician, I listen to a family and understand their perspectives and together develop a clear and agreed plan.

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