Bioethics Blogs

Innovation for End-of-Life Communication in the ICU

A recent article in the American Journal of Respiratory and Critical Care Medicine offers great advice on communication in the ICU.

This is important, because “once the family has expressed a choice, it is much harder to talk them out of it an the process becomes contentious rather than shared.” Small tweaks to the words we use can make a big difference.

“Family meetings in the ICU aim to facilitate preference sensitive treatment decisions through shared decision making. To elicit information about patient preferences the Society of Critical Care Medicine endorses questions like ‘what would she want?’”

“However use of the word ‘want’ may be particularly problematic as it encourages surrogates to express desires that are not grounded in the clinical context. Although it is common practice to ask what a patient might want, this question can lead to worse decision making and less exchange of information about patient’s values.”

“Attention to word choice is important. To improve surrogate decision making, clinicians should ask family members what their loved one might say or think about the patient’s health state.”

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.