LETTERS TO THE EDITORS

To the Editors:

Many patients in ICUs reach a point when it can be reasonably inferred that meaningful survival is not likely and continued medical interventions are deemed futile.¹ At this point, the physician makes a decision in concert with an interdisciplinary team to withdraw care. The phrase withdrawing care typically originates from the medical profession, but its perceived meaning is rarely challenged by nursing. Use of phrases such as withdrawing care is inappropriate. The discipline and profession of nursing should uphold the social contract of patient advocacy by critiquing this phrase and avoiding its use when discussing potential end-of-life planning.

The role of the nurse as an advocate for patients is not a new concept. From the beginning of our education we learn that advocacy, grounded in a framework of caring, is at the very core of our existence in the health-care system. Further, in 1980, the American...