Limiting futile therapy as part of end-of-life care in intensive care units
The debate about medical futility often involves intensive care units where life-support procedures are routinely applied. Futile therapy is part of end-of-life therapy. In the discussion about medical futility it is important to distinguish the effect of therapy from the benefit for the patient....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Termedia Publishing House
2022-09-01
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| Series: | Anaesthesiology Intensive Therapy |
| Subjects: | |
| Online Access: | https://www.termedia.pl/Limiting-futile-therapy-as-part-of-end-of-life-care-in-intensive-care-units,118,47723,1,1.html |
| Summary: | The debate about medical futility often involves intensive care units where life-support
procedures are routinely applied. Futile therapy is part of end-of-life therapy. In the
discussion about medical futility it is important to distinguish the effect of therapy from
the benefit for the patient. The goal of treatment is not to maintain the function of
an organ, body part or physiological activity, but to maintain health as a whole. Prolonging
ineffective treatment violates the standard of good medical practice.
In 2014, the first Polish guidelines on limiting futile therapy in patients treated in intensive
care units were published. This document presents the official position of intensive
care experts consulted by medical societies of other medical disciplines.
Limitation of futile therapy by withdrawing from already used treatments or withholding
new therapies does not mean that the role of medical personnel has ended. Intensive
care turns into palliative care.
The list of comorbidities showing a statistically significant correlation with medical
futility has been refined. These include heart failure (NYHA III/IV), neoplastic disease and
disseminated neoplastic process, and failure of two or more organs.
The published survey results are devastating; 66-89% of intensive care nurses have provided
futile treatment in their careers. Intensivists estimated that, on average, 20% of
patients in intensive care units receive futile therapy.
There is a need to disseminate standards and procedures related to end-of-life care in
Polish intensive care units. |
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| ISSN: | 1642-5758 1731-2531 |