End-of-life decision making in ICU

I applaud Mary Thelan for the excellent article, End-of-Life Decision Making in Intensive Care (December 2005:28–37). As she noted, because of the ability of medicine and nursing to offer extraordinary support that extends life, families need more help to understand complex medical treatments and to support decision making regarding patient care. My experience with an interdisciplinary model supports the author’s acknowledgment of this being an effective model for decision making in the intensive care unit (ICU). As the manager of an ICU, I established a protocol for an interdisciplinary family conference to improve communication and the quality of care in the ICU. My experience has been that fine-tuning the plan of care by this method does indeed clarify end-of-life (EOL) goals.

Evidence suggests that providing family guidance correlates to the clarification of goals at the EOL. Ahrens et al¹ developed a team to improve communication with families who had...