Biomaterial Database

Withdrawing and withholding treatment in intensive care. Part 3. Practical aspects. 1990

M M Fisher, and R F Raper

Royal North Shore Hospital, St Leonards, NSW.

A major goal of intensive care units should be to provide an environment in which death may occur with dignity if cure is impossible. The key issues in providing such an environment are the establishment of consensus that cure is impossible, and the provision of a resource person who has been a major participant in efforts to cure the patient. This person leads discussion with the patient or relatives, seeking concurrence rather than permission when the withdrawing or withholding of care is under consideration. We present problems which may arise in facilitating a dignified demise, and a practical approach to these problems.

UI	MeSH Term	Description	Entries
D010166	Palliative Care	Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)	Palliative Treatment,Palliative Supportive Care,Palliative Surgery,Palliative Therapy,Surgery, Palliative,Therapy, Palliative,Care, Palliative,Palliative Treatments,Supportive Care, Palliative,Treatment, Palliative,Treatments, Palliative
D010344	Patient Advocacy	Promotion and protection of the rights of patients, frequently through a legal process.	Patient Ombudsmen,Patient Representatives,Clinical Ombudsman,Patient Ombudsman,Advocacy, Patient,Ombudsman, Clinical,Ombudsman, Patient,Ombudsmen, Patient,Patient Representative,Representative, Patient,Representatives, Patient
D010358	Patient Participation	Patient involvement in the decision-making process in matters pertaining to health.	Patient Activation,Patient Empowerment,Patient Engagement,Patient Involvement,Patient Participation Rates,Activation, Patient,Empowerment, Patient,Engagement, Patient,Involvement, Patient,Participation Rate, Patient,Participation Rates, Patient,Participation, Patient,Patient Participation Rate
D003422	Critical Care	Health care provided to a critically ill patient during a medical emergency or crisis.	Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D004992	Ethics, Medical	The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families.	Medical Ethics
D004993	Ethics, Nursing	The principles of proper professional conduct concerning the rights and duties of nurses themselves, their patients, and their fellow practitioners, as well as their actions in the care of patients and in relations with their families.	Nursing Ethics,Ethic, Nursing,Nursing Ethic
D005066	Euthanasia, Passive	Failing to prevent death from natural causes, for reasons of mercy by the withdrawal or withholding of life-prolonging treatment.	Allowing to Die,Euthanasia, Negative,Negative Euthanasia,Passive Euthanasia
D005190	Family	A social group consisting of parents or parent substitutes and children.	Family Life Cycles,Family Members,Family Life Cycle,Family Research,Filiation,Kinship Networks,Relatives,Families,Family Member,Kinship Network,Life Cycle, Family,Life Cycles, Family,Network, Kinship,Networks, Kinship,Research, Family
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012297	Right to Die	The right of the patient or the patient's representative to make decisions with regard to the patient's dying.	Death with Dignity,Dignity, Death with