Dr Jeannie P. Cimiotti joins Ethics Talk to discuss her article, coauthored with Drs Kimberly Adams Tufts, Lucia D. Wocial, and Elizabeth Peter: “How Should Focus Be Shifted From Individual Preference to Collective Wisdom for Patients at the End of Life With Antimicrobial-Resistant Infections?”
Physicians need to manage expectations and clearly explain the prognosis of ICU patients to their families, particularly when the outcome is a negative one.
Lorraine M. Stone, MD, MSPH and James A. Tulsky, MD
Physicians should develop a specific strategy for talking to relatively healthy patients about their CPR preferences in the event they become seriously ill in the future.
Physicians and surrogates should take patients' preferences into account in making clinical intervention decisions, even if the patients have been found to lack decision-making capacity.
Physicians and surrogates should take patients' preferences into account in making clinical intervention decisions, even if the patients have been found to lack decision-making capacity.
Physicians and surrogates should take patients' preferences into account in making clinical intervention decisions, even if the patients have been found to lack decision-making capacity.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.
One strategy is to determine “triggers” that alert the primary clinician that the patient has a high symptom burden or difficulty coping with the diagnosis, prognosis, or treatment plans and should be offered palliative care services.