New Guidelines Address Conflicts in Critical Care Treatment
Chicago, Il - "Neither individual clinicians nor families should be given unchecked authority to determine what treatments will be given to a patient," explained Douglas White, M.D., M.A.S., UPMC Chair for Ethics in Critical Care Medicine, associate professor in the University of Pittsburgh Department of Critical Care Medicine, and co-chair of the committee that produced these guidelines. "Clinicians should neither simply acquiesce to treatment requests that they believe are not in a patient's best interest, nor should they unilaterally refuse to provide treatment. Instead, if conflicts arise between clinicians and patients' families, a fair process of dispute resolution should be undertaken, in which neither individual can unilaterally impose his or her will on the other."
The guidelines, which will appear in the June 1st issue of the American Journal of Respiratory and Critical Care Medicine and are available online, are a new resource for an estimated 80,000 health professionals. They are supported by the Society of Critical Care Medicine, the American Association of Critical Care Nurses, the American College of Chest Physicians and the European Society of Intensive Care.
When a clinician is asked by the family of a critically ill patient to administer invasive interventions that the clinician believes will not benefit the patient, "such disagreements can present particular challenges, since they bring into conflict important interests of patients, clinicians and society," Dr. White said. "The cases are difficult because there are generally no clear, substantive rules to appeal to and because ICU patients are especially vulnerable because of their overwhelming illness and lack of ability to seek out another doctor if they disagree with the plan." Continue>
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