A Practical Approach to Humanizing Care for Patients Who Are Expected to Die in an Intensive Care Unit
Authors: John Hansen-Flaschen
Journal: Annals of Internal Medicine (2015)

Editorials18 August 2015A Practical Approach to Humanizing Care for Patients Who Are Expected to Die in an Intensive Care UnitJohn Hansen-Flaschen, MDJohn Hansen-Flaschen, MDFrom University of Pennsylvania, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1351 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fully realized intensive care units (ICUs) pursue 3 complementary objectives in the care of critically ill patients: rescue, early rehabilitation, and palliation. Balanced pursuit of those objectives shifts perceptions of ICUs away from places for the application of specialized life-supporting technologies to places where a diverse complement of specialized clinicians team up to meet the various needs of critically ill patients as they evolve over time.Intensivists who still fixate on the electrical devices that encircle the beds and the many numbers they generate resist the notion that the palliative objective of ICUs should extend beyond symptom management to nontechnical ...References1. Cook D, Swinton M, Toledo F, Clarke F, Rose T, Hand-Breckenridge T, et al. Personalizing death in the intensive care unit: the 3 Wishes Project. A mixed-methods study. Ann Intern Med. 2015;163:271-9. doi:10.7326/M15-0502 LinkGoogle Scholar2. Ewing B. Wish fulfillment: palliative care and end-of-life intervention. Pediatr Nurs. 2009;35:81-5. [PMID: 19472670] MedlineGoogle Scholar3. Carter BS, Brown JB, Brown S, Meyer EC. Four wishes for Aubrey. J Perinatol. 2012;32:10-4. [PMID: 22094491] doi:10.1038/jp.2011.171 CrossrefMedlineGoogle Scholar4. Make-A-Wish Foundation of America. Accessed at www.wish.org on 6 June 2015. Google Scholar5. Darlington AS, Heule F, Passchier J. Granting wishes: parents' perception of a wish fulfillment for a child with a life-threatening illness. Acta Paediatr. 2013;102:e480-2. [PMID: 23834650] doi:10.1111/apa.12345 CrossrefMedlineGoogle Scholar6. Schilling ML, Sarigiani P. The impact of a wish: caregiver perceptions of the benefits of granted wishes for children with life-threatening illnesses and their families. Children's Health Care. 2014;43:16-38. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAuthors: John Hansen-Flaschen, MDAffiliations: From University of Pennsylvania, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1351.Corresponding Author: John Hansen-Flaschen, MD, Paul F. Harron, Jr. Family Professor of Medicine, Pulmonary, Allergy and Critical Care Division, Department of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, 373 Maloney Building, Philadelphia, PA 19096; e-mail, [email protected]upenn.edu.This article was published online first at www.annals.org on 14 July 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPersonalizing Death in the Intensive Care Unit: The 3 Wishes Project Deborah Cook , Marilyn Swinton , Feli Toledo , France Clarke , Trudy Rose , Tracey Hand-Breckenridge , Anne Boyle , Anne Woods , Nicole Zytaruk , Diane Heels-Ansdell , and Robert Sheppard Personalizing Death in the Intensive Care Unit: The 3 Wishes Project Deborah Cook , Marilyn Swinton , Feli Toledo , France Clarke , Trudy Rose , Tracey Hand-Breckenridge , Anne Boyle , Anne Woods , Nicole Zytaruk , Diane Heels-Ansdell , and Robert Sheppard Metrics Cited byImproving ICU-Based Palliative Care DeliveryClinician Perspectives on an Electronic Portal to Improve Communication with Patients and Families in the Intensive Care Unit 18 August 2015Volume 163, Issue 4Page: 318-319KeywordsChildrenCritical careDisclosureEnd of life careHospital medicineIntensive care unitsPalliative carePatientsPerceptionScientists ePublished: 18 August 2015 Issue Published: 18 August 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...