TY  - CHAP
M1  - Book, Section
TI  - Ethics and Palliative Care in the Intensive Care Unit
A1  - Hope, Aluko A.
A2  - Oropello, John M.
A2  - Pastores, Stephen M.
A2  - Kvetan, Vladimir
Y1  - 1
N1  - 
T2  - Critical Care
AB  - KEY  POINTSThe  four  principles  of  biomedical  ethics—beneficence,  nonmaleficence,  autonomy,  and  justice  can  provide  a  rubric  through  which  clinicians  can  identify  ethical  dilemmas  in  clinical  practice.Informed  consent  is  a  process  of  mutual  respect  between  a  clinician  and  a  patient  that  involves  (a)  ensuring  that  the  patient  has  the  capacity  to  make  the  specific  medical  decision;  (b)  the  skillful  disclosure  of  relevant  information  to  the  patient;  and  (c)  ensuring  that  the  patient’s  expressed  choices  are  voluntary.Advance  care  planning  is  a  process  by  which  patients,  with  facilitation  by  a  trained  professional,  clarifies  their  current  health  state,  goals,  and  objectives.A  living  will  is  any  document  where  the  patient  anticipates  a  specific  set  of  medical  circumstances  and  requests  or  refuses  specific  types  of  treatment  under  each  of  these  medical  circumstances.A  health  care  proxy  form  allows  a  patient  to  name  a  surrogate  decision-maker  in  the  event  they  become  unable  to  make  medical  decisions  for  themselves.In  shared  decision-making,  clinicians  are  considered  the  experts  on  prognosis/treatment  options,  whereas  the  patient/family  is  considered  the  expert  on  the  patient’s  values.Palliative  care  is  a  multidisciplinary,  patient-centered  approach  to  care  that  focuses  on  (a)  assessing  and  treating  symptoms;  (b)  providing  psychological  and  spiritual  support  to  patients  and  families;  (c)  facilitating  treatments  that  are  better  aligned  with  patients’  values  by  ensuring  skillful,  proactive,  and  compassionate  communication  between  the  clinical  team  and  the  patients/families.Most  patients  die  in  the  ICU  after  the  withdrawal  or  withholding  of  some  life-sustaining  treatments.The  withdrawal  of  life-sustaining  treatments  should  be  considered  a  clinical  procedure  that  requires  expertise,  careful  preparation,  appropriate  documentation,  and  ongoing  evaluation.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1136418770
ER  -