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Báo cáo y học: "Beyond ethical dilemmas: improving the quality of end-of-life care in the intensive care unit"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Beyond ethical dilemmas: improving the quality of end-of-life care in the intensive care unit. | Available online http ccforum.eom content 7 1 11 Commentary Beyond ethical dilemmas improving the quality of end-of-life care in the intensive care unit Gordon D Rubenfeld1 and J Randall Curtis2 Assistant Professor of Medicine Division of Pulmonary and Critical Care Medicine Harborview Medical Center University of Washington Seattle Washington USA 2Associate Professor of Medicine Division of Pulmonary and Critical Care Medicine Harborview Medical Center University of Washington Seattle Washington USA Correspondence Gordon D Rubenfeld nodrog@u.washington.edu Published online 18 December 2002 Critical Care 2003 7 11-12 DOI 10.1186 cc1866 This article is online at http ccforum.com content 7 1 11 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Consensus guidelines on providing optimal end-of-life care in the intensive care unit ICU are important tools. However despite 30 years of ethical discourse and consensus on many of the principles that guide end-of-life care in the ICU care remains inadequate. Although consensus on the most challenging ethical aspects of some cases will remain elusive this need not deter clinicians from engaging in practical quality improvement best practice and educational interventions to provide compassionate care to all critically ill patients including those who ultimately die. Keywords consensus guidelines end-of-life care palliative care quality improvement The consensus guidelines developed by Hawryluck and coworkers 1 provide a nice summary of the current principles that guide palliative care in the intensive care unit ICU . Although recommendations in that article can be found in a variety of published guidelines on end-of-life care in the ICU 2-5 this Delphi-based consensus study provides useful additions. The Intent section in Table 4 of the report by Hawryluck and coworkers 1 is particularly helpful to clinicians trying to understand the practical implications of the principle of double effect . Specific .