Ethical conflicts in intensive care units (ICUs) often reflect a tension between patients’ expectations and providers’ autonomy regarding medically appropriate care. These conflicts can cause moral distress for patients, families, and health care providers. Pavlish and colleagues developed an ethics screening tool for nurses to assess early indictors of ethical dilemmas and to analyze the level of risk likely to develop in specific situations. Use of the tool helped nurses to do the following:

  • Proactively screen specific patient situations

  • Clarify complicated clinical issues for better understanding and communication with the health care team

  • Initiate difficult conversations with team members, patients, and families.

The authors advocate early screening for all patients and recommend that interventions such as family care conferences, ethical consultations, and palliative care services become more prominent and routine in the care of critically ill patients.

—Rhonda Board, rn, ph...

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