The ICU as a hospice-What the benefits and who bears the cost?

摘要

Epidemiological studies show that most hospital deaths occur in ICU, regardless of the age of the patient. However, while some patients die during active organ support, for others, treatment priorities change from curative to palliative and a decision is needed about future care location. This editorial examines the complexities of such decisions, the impact of internal and external factors and what this may mean for patients, families and clinicians. Questions arise such as: what does 'expensive' mean in the context of palliative intensive care? How can we provide quality end of life care in a noisy ICU with visiting restrictions? Do we make assumptions about what the patient would prefer?