Palliative Care in Intensive Care Units

Abstract

For many patients treated in intensive care units (ICUs), clinicians must address complex disease processes and physiology while also helping patients and their family members navigate difficult decisions about life and death. The skills necessary to do this are embodied in the principles of palliative care. Palliative care is provided to patients and family members of patients with serious, life-limiting illness. This type of care entails a holistic approach to the patient, incorporating high-quality communication and management of physical symptoms, psychological distress, and spiritual needs with a goal of improving patients’ quality of life. In this chapter, we discuss how these skills can be used to help clinicians as they engage in shared decision-making with patients and family as well as within the interdisciplinary team. By engaging in conversations about serious illness, acknowledging the emotions of patients and clinicians, and providing culturally competent care, ICU clinicians can use palliative care to prevent many ethical dilemmas from arising. In cases where conflict does occur, specialists may play a role in mitigating disagreements about care.