To the Editors:

Having read the November 2005 issue, there are several things I want to address. My colleague, M. Jean Reed, rn/bsn, and I conducted extensive research over 2 years’ time on end-of-life care in our ICU. Not only did we identify the ongoing lack of communication between nurses/physicians and families, we noted the significant increase in indirect costs when life is prolonged without a goal, an end point, or any realistic hope of improvement. Projected savings over the course of a year, if the program we designed had been put into place, was estimated in the millions.

In the journal articles, the authors make a specific distinction between ICU end-of-life issues and palliative care. We wholeheartedly agree. They are not, and have never been, the same thing. This was always difficult to make people understand in the course of our research and development of the...

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