Conflict over treatment withdrawal in the intensive care unit, a description of the health care providers' experience

grantor: University of TorontoConflict over treatment withdrawal between intensive care unit (ICU) staff and patients or their family members has unfortunately become a common aspect of the practice of intensive care medicine. This conflict has given rise to a large body of ethical, legal, policy and empirical literature about what has come to be known as futile treatment. This body of literature has attempted to determine when and under what circumstances health care staff are obligated to provide life sustaining treatments they believe to be futile or inappropriate. This study examines the problem of futile treatment based upon case descriptions provided by 12 ICU nurses and physicians. Qualitative methods were used to analyze the interview transcripts. The results demonstrate that conflict over treatment withdrawal is comprised of multiple interrelated facets, including the patient, family members, providers, resources considerations, palliative care, goals of the ICU and policy approaches. In order for conflict over treatment withdrawal to be effectively and humanely addressed these differing aspects need to be acknowledged and addressed. Tentative solutions and courses for future research are presented.M.Sc