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....

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Main Authors: Maria Damps, Maksymilian Gajda, Ludwik Stołtny, Małgorzata Kowalska, Ewa Kucewicz-Czech
Format: Article
Language:English
Published: Termedia Publishing House 2022-09-01
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
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author Maria Damps
Maksymilian Gajda
Ludwik Stołtny
Małgorzata Kowalska
Ewa Kucewicz-Czech
author_facet Maria Damps
Maksymilian Gajda
Ludwik Stołtny
Małgorzata Kowalska
Ewa Kucewicz-Czech
author_sort Maria Damps
collection DOAJ
description 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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spelling doaj.art-70517c94c5f042b68a966bfe91a154c82023-01-25T12:56:44ZengTermedia Publishing HouseAnaesthesiology Intensive Therapy1642-57581731-25312022-09-0154327928410.5114/ait.2022.11912447723Limiting futile therapy as part of end-of-life care in intensive care unitsMaria DampsMaksymilian GajdaLudwik StołtnyMałgorzata KowalskaEwa Kucewicz-CzechThe 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.https://www.termedia.pl/Limiting-futile-therapy-as-part-of-end-of-life-care-in-intensive-care-units,118,47723,1,1.htmlfutile therapy palliative care autonomy of patient communication with the patient and his family
spellingShingle Maria Damps
Maksymilian Gajda
Ludwik Stołtny
Małgorzata Kowalska
Ewa Kucewicz-Czech
Limiting futile therapy as part of end-of-life care in intensive care units
Anaesthesiology Intensive Therapy
futile therapy
palliative care
autonomy of patient
communication with the patient and his family
title Limiting futile therapy as part of end-of-life care in intensive care units
title_full Limiting futile therapy as part of end-of-life care in intensive care units
title_fullStr Limiting futile therapy as part of end-of-life care in intensive care units
title_full_unstemmed Limiting futile therapy as part of end-of-life care in intensive care units
title_short Limiting futile therapy as part of end-of-life care in intensive care units
title_sort limiting futile therapy as part of end of life care in intensive care units
topic futile therapy
palliative care
autonomy of patient
communication with the patient and his family
url https://www.termedia.pl/Limiting-futile-therapy-as-part-of-end-of-life-care-in-intensive-care-units,118,47723,1,1.html
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AT małgorzatakowalska limitingfutiletherapyaspartofendoflifecareinintensivecareunits
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