Bioethics Blogs

Critical Care Nurses Urge Physicians Not Allow Families to Override Patient Wishes. Many

A new study in the July/August 2017 Dimensions of Critical Care Nursing  reports suggestions from 500 critical care nurses on how to improve end-of-life care obstacles.  

Major themes include:

  • Ensuring characteristics of a good death
  • Improving physician communication with patients and families
  • Adjusting nurse-to-patient ratios to 1:1
  • Recognizing and avoiding futile care
  • Increasing EOL education
  • Physicians who are present and ‘‘on the same page”
  • Need for more support staff
  • Not allowing families to override patients’ wishes

I want to second this final suggestion.  In my discussions with nurses this is a very common question.  The study’s quotes are consistent with my own experience:

  • “The most troubling aspect is when patients’ wishes are not followed.”
  • “Respect patients’ wishes NOT families!”
  • “Follow the patient’s DNR/POLST form regardless of the family’s wishes. The patient filled it out for a reason.”
As I have written several times, surrogates who contradict the patient’s own instructions or wishes can and should be replaced.  

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.