Futile Treatment In Critical Care

Futile Treatment in Critical Care Unit

Introduction

In many critical care units there are always some patients who receive treatment or interventions to prolong their lives. These interventions include mechanical ventilations, dialysis, inotropes support and so on. According to Huynh (2014), when critical care is used to prolong life without achieving a benefit meaningful to the patient, it is usually considered "futile". He had conducted a survey in five ICUs for three months, there were 123 patients been assessed to receive futile treatment among 1136 patient (Huynh, 2014). Towards the end of life, the physician will have to face the dilemma when to discontinue life sustaining treatments or interventions. The conflict will

They need to consider patient’s quality of life and the effectiveness of the treatment and how responsive of the patient to the treatment etc. Beachamp and Childress (2009) have defined four key principles of biomedical ethics: non-maleficence, beneficence, respect for autonomy and justice. Based on these ethical principles, the physician should make the decision to provide standard care for the patient and the appropriate use of medical resources (Baily, 2011). Non-maleficence means do no harm to the patient, and beneficence means do something which will benefit the patient (Thompson, 2011). In this case, dialysis will not help much in his condition and may cause pain or discomfort to the patient. While his family want him to go through it. How the physician make the decision? They will need to look into the other two

The multidisciplinary team including physician, nurses, social workers and case managers should be all attended. It is necessary to care for families facing the ethical dilemmas of futile care with sufficient medical knowledge, ethical knowledge and communication skills (Coustasse, 2008). The nurses as a caregiver and advocate for patient, they have the responsibility to provide the primary care for the patient and work independently, including prioritizing care needs, managing bedside technology, and acting as the primary support and first source of information for the families (Payne, 2009).They spend more time with the patient than any other clinicians and they are always present during patient suffering (Hamric and Blackhall 2007). The futile treatment may cause pain or discomfort for the patient. Their perspectives are important for end of life discussions (Hamric and Blackhall 2007). That is why nurses should also be involved in end of life decision making, which makes nursing and medical perspectives be able to share with families’ perspectives to achieve a consensus (Bloomer,