An examination of families' experiences when deciding to remove life-sustaining interventions in the intensive care unit (ICU).
Written in 2007; 3,164 words; 14 sources; APA; $ 91.95
Paper Summary:
This paper explores the experience of family members who are engaged in decision-making related to the withdrawal or withholding of life-sustaining interventions from another family member. It explains that the methodology used consists of a sample of four to five families who are contacted through ICU family conferences in one or two hospitals in which the conferences are concerned with the withholding or withdrawal of life support from a family member. The paper looks at how certain factors may be identified from family members' experiences that help to determine why the decision-making process is subject to wide variation.
The paper also notes that it is expected that certain family members engage in more effective decision making than others and that particular families engage in more effective decision making than other families. The paper highlights the fact that family decisions are rendered easier or more problematic by such variables as the person's prognosis, whether an acute or chronic illness is involved, perceived quality of life, degree of suffering, and the presence of an advance directive. The paper concludes that preparation for death most especially needs to be based in a team approach, and the emphasis should be upon the relationship between nurses and families and that the future needs of the family should be proactively considered once death has occurred.
From the Paper:
"Nurses and other healthcare providers normally initiate the discussion that lead to withdrawal of life-support but patients and families make the final decision. The experience of decision making is different for family members when an acute illness is involved from a situation of chronic illness. After a period of denial, families of patients with acute illness or injury can recognize the need for withdrawal of support much more quickly (McHale Wiegand, 2006). Certain behaviors by healthcare providers can increase the level of distress experienced by the patient's family."
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