Framework for decision-making and management of end-of-life decisions in Intensive Care Units: A modified protocol
Namrata Maheshwari, Alex Psirides, Amit K. Mandal
Checklist, end-of-life decisions, Intensive Care Unit
Citation Information :
Maheshwari N, Psirides A, Mandal AK. Framework for decision-making and management of end-of-life decisions in Intensive Care Units: A modified protocol. Indian J Crit Care Med 2015; 19 (11):655-660.
End-of-life decisions are being made daily in Intensive Care Units worldwide. The spectrum of options varies from full-continued care, withholding treatment, withdrawing treatment, and active life-ending procedures depending on the institutional practices and legal framework. Considering the complexity of the situation and the legalities involved, it is important to have a structured approach toward these sensitive decisions. It does make sense to have a protocol that ensures proper documentation and helps ease the physicians involved in such decisions. Clear documentation in the format of a checklist would ensure consistency and help the entire medical team to be uniformly informed about the end-of-life plan.
Rothman DJ. Where we die. N Engl J Med 2014;370:2457-60.
Angus DC, Barnato AE, Linde-Zwirble WT, Weissfeld LA, Watson RS, Rickert T, et al. Use of intensive care at the end of life in the United States: An epidemiologic study. Crit Care Med 2004;32:638-43.
Ventres W. Educating our patients about life and the end of life: Toward a pedagogy of dying. J Am Board Fam Med 2014;27:713-6.
Romain M, Sprung CL. End-of-life practices in the intensive care unit: The importance of geography, religion, religious affiliation, and culture. Rambam Maimonides Med J 2014;5:e0003.
Psirides AJ, Sturland S. Withdrawal of active treatment in intensive care: What is stopped - Comparison between belief and practice. Crit Care Resusc 2009;11:210-4.
Bloomer MJ, Tiruvoipati R, Tsiripillis M, Botha JA. End of life management of adult patients in an Australian metropolitan intensive care unit: A retrospective observational study. Aust Crit Care 2010;23:13-9.
Datta R, Chaturvedi R, Rudra A, Jaideep CN. End of life issues in the intensive care units. Med J Armed Forces India 2013;69:48-53.
Myatra SN, Salins N, Iyer S, Macaden SC, Divatia JV, Muckaden M, et al. End-of-life care policy: An integrated care plan for the dying: A Joint Position Statement of the Indian Society of Critical Care Medicine (ISCCM) and the Indian Association of Palliative Care (IAPC). Indian J Crit Care Med 2014;18:615-35.
Medical Treatment of Terminally Ill Patients (for the Protection of Patients and Medical Practitioners). 196 th Report of Law Commission of India; 2006. Available from: http://www.lawcommissionofindia.nicin/reports/report196.pdf. [Last accessed on 2015 May 05].
Passive Euthanasia - A Relook. 241 st Report of Law Commission of India; 2012. Available from: http://www.lawcommissionofindia.nic.in/reports/report241.pdf. [Last accessed on 2015 May 28].
Aruna Ramakrishna Shanbaugh vs. The Union of India and Ors. 2011 4 SCC 454 and 524. Writ petition (crl.) no(s). 115 of 2009, date: 07/03/2011 SC. Available from: http://www.supremecourtofindia.nic.in/outtoday/wr1152009.pdf. [Last accessed on 2015 Nov 1].
Carlet J, Thijs LG, Antonelli M, Cassell J, Cox P, Hill N, et al. Challenges in end-of-life care in the ICU. Statement of the 5 th International Consensus Conference in Critical Care: Brussels, Belgium, April 2003. Intensive Care Med 2004;30:770-84.
Psirides A. Allow a Natural Death in Intensive Care - Wellington Intensive Care Unit. AND-ICU form v6.1; October, 2015. Available from: http://www.wellingtonicu.com/Data/ANDICU.pdf. [Last accessed on 2015 Oct 15].
Matsumura Y, Nakada TA, Abe R, Oshima T, Oda S. Serum procalcitonin level and SOFA score at discharge from the intensive care unit predict post-intensive care unit mortality: A prospective study. PLoS One 2014;9:e114007.
Cardona-Morrell M, Hillman K. Development of a tool for defining and identifying the dying patient in hospital: Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL). BMJ Support Palliat Care 2015;5:78-90.
Greer DM, Curiale GG. End-of-life and brain death in acute coma and disorders of consciousness. Semin Neurol 2013;33:157-66.
Australian and New Zealand Intensive Care Society. ANZICS Statement on Care and Decision-Making at the End of Life for the Critically Ill (Edition 1.0). Melbourne: ANZICS; 2014. Available from: http://www.anzics.com.au/Downloads/ANZICS%20Statement%20on%20Care%20and%20Decision-Making%20at%20the%20End%20of%20Life%20for%20the%20Critically%20Ill.pdf [Last accessed on 2015 May 25].