Tag: ethics
How Should ECMO Initiation and Withdrawal Decisions Be Shared?
Extracorporeal membrane oxygenation (ECMO) is a new technology used to rescue patients with severe circulatory or respiratory failure and help bridge them to recovery or to definitive therapies like device implantation or... read more
Research Ethics and Informed Consent in Critical Care
Research studies in critically ill populations pose many unique regulatory and ethical challenges that have implications for study design and execution. The life-threatening nature of conditions being studied and the urgency... read more
Ethical Dilemmas in Pediatrics
Children in precarious health present particular problems for healthcare professionals because of their intimate relation to their family, and because of the family's need to provide major long-term source of support and... read more
Graceful Exit: How to Advocate Effectively, Take Care of Yourself, and Be Present for the Death of a Loved One
When we are thrust into the role of caregiver for a loved one who is in the process of dying, it's easy to get overwhelmed. Yet it's a situation millions of us face every year with virtually no sort of preparation or guidance.... read more
Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness
The Hospital Elder Life Program is effective in reducing incidence of delirium and rate of falls, with a trend toward decreasing length of stay and preventing institutionalization. With ongoing efforts in continuous program... read more
Humanizing the ICU
In the midst of trying to correct organ failures, clinicians may neglect to carefully consider what the patient is experiencing: to be on the brink of death, be unable to speak, be stripped naked, have strangers enter the... read more
Ethical dilemmas in Emergency Medicine
When we talk about triage, we could mean several things. We might mean the triage of patients arriving in the ED to assign clinical priority (because not everyone can be seen instantly); we might mean the triage of patients... read more
When health professionals have empathy, patients aren’t the only ones who benefit
What do doctors and religious leaders have in common? At least a couple of big things: individuals in both professions engage with people at some of the most critical moments in their lives and require a high degree of empathy... read more
The white coat means something more to patients
How do we choose what we wear when seeing patients? Is it by what tradition dictates? Do we need to meet our institution's dress code? Or do we just like what makes us comfortable? (Those scrubs sure are comfy — almost... read more
Failures in the Respectful Care of Critically Ill Patients
Care that is inadequately respectful to patients and families in the setting of critical illness is prevalent but does not appear to be associated with clinical characteristics. The incidence of such emotional harms is nuanced,... read more
Time-limited Trial of Intensive Care Treatment
In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition,... read more
Effectively Expressing Empathy to Improve ICU Care
In nearly every intensive care unit (ICU) at every pediatric hospital across the country, physicians hold numerous care conferences with patients' family members daily. Due to the challenging nature of many these conversations--covering... read more
Establishing a Relationship of Trust and Care
An admission to the intensive care unit (ICU) is often a traumatic experience for both patients and families. Although members of the critical care team are specially trained to provide care and treatment requiring close,... read more
Practicing Respect in the ICU
In this episode, we discuss the practice of respect in the ICU. Our guest is Samuel M. Brown, MD, MS, a practicing intensivist and Director of the Center for Humanizing Critical Care at Intermountain Medical Center in Murray,... read more
Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician
The educational and social milieu of medical learning environments is a complex system of influences. Role models across peer relationships and the hierarchy of medicine contribute to the formation of professional identity,... read more
Extreme Measures: Finding a Better Path to the End of Life
In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused,... read more
Should doctors be required to inform patients of their palliative care rights?
I overheard a colleague admit an 84-year-old woman to the hospital from the emergency department for a sizable mass in her uterus — no doubt, cancerous. I pictured a frail woman who’d been suffering for a while and was... read more
Receiving a Letter of Condolence After Loss of a Loved One in the ICU
This study describes the benefits of receiving a letter of condolence; mainly, it humanizes the medical institution (feeling of support, confirmation of the role played by the relative, supplemental information). However,... read more
Outcomes of Ethics Consultations in Adult ICUs
Our review identified outcome-based assessment as the predominant measure used to report effectiveness of clinical ethics consultation consultations. In particular, clinical ethics consultation decreased ICU length of stay... read more
Monitoring ICU Performance-impact of a Novel Individualised Performance Scorecard in Critical Care Medicine
Patients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance... read more
Factors Associated with Life-Sustaining Treatment Restriction in the ICU
Few previous studies have investigated associations between clinical variables available after 24 hours in the ICU and decisions to restrict life-sustaining treatment. The aim of this study was to identify factors associated... read more
