Intensive Care Med (2011) 37:1143–1150 DOI 10.1007/s00134-011-2253-x O R I G I N A L Ranveig Lind Geir F. Lorem Per Nortvedt Olav Hevrøy Family members’ experiences of ‘‘wait and see’’ as a communication strategy in end-of-life decisions Received: 24 August 2010 Accepted: 1 April 2011 Published online: 28 May 2011 The Author(s) 2011. This article is published with open access at Springerlink.com Electronic supplementary material The online version of this article (doi:10.1007/s00134-011-2253-x) contains supplementary material, which is available to authorized users. R. Lind ()) Intensive Care Unit, University Hospital of Northern Norway, Opin-klin, Pb 6060, 9038 Tromsø, Norway e-mail: Ranveig.Lind@unn.no Tel.: ?47-91184108 Fax: ?47-77626192 R. Lind G. F. Lorem Department of Care and Health Sciences, University of Tromsø, Tromsø, Norway G. F. Lorem e-mail: geir.lorem@uit.no Tel.: ?47-77646533 P. Nortvedt Section for Medical Ethics, University of Oslo, Oslo, Norway e-mail: p.nortvedt@medisin.uio.no O. Hevrøy be unclear, and few study participants Intensive Care Unit, Haukeland University experienced shared decision-making. Hospital, Bergen, Norway The clinician’s expression ‘‘wait and e-mail: olav.hevroy@helse-bergen.no see’’ hides and delays the communi- cation of honest and clear Abstract Purpose: The aim of information. When physicians ﬁnally this study is to examine family address their decision, there is no members’ experiences of end-of-life time for family participation. Our decision-making processes in Nor- results also indicate that nurses wegian intensive care units (ICUs) to should be more involved in family– ascertain the degree to which they felt physician communication. Conclu- included in the decision-making pro- sions: Families are uncertain cess and whether they received whether or how they can participate necessary information. Were they in the decision-making process. They asked about the patient’s preferences, need unambiguous communication and how did they view their role as and honest information to be able to family members in the decision- take part in the decision-making pro- making process? Methods: A con- cess. We suggest that clinicians in structivist interpretive approach to the Norwegian ICUs need more training grounded theory method of qualita- in the knowledge and skills of effec- tive research was employed with tive communication with families of interviews of 27 bereaved family dying patients. members of former ICU patients 3–12 months after the patient’s death. Keywords Intensive care Results: The core ﬁnding is that End of life Decision-making relatives want a more active role in Communication Family members end-of-life decision-making in order to communicate the patient’s wishes. However, many consider their role to Introduction involving serious interventions should be based on informed consent [2]. However, ICU patients generally Most deaths in intensive care units (ICUs) take place after have impaired cognition and are unable to decide for a decision is made to limit or withdraw medical treatment. themselves; therefore, they depend on surrogates to make Questions regarding the level and aim of treatment form decisions on their behalf [3]. Traditionally, and due to an important part of day-to-day activities in ICUs [1]. legislation, families in European countries have been less According to Norwegian legislation, healthcare decisions involved in end-of-life decisions than in the USA [4–6].