Hola a tod@s, my beloved rogue.
Published yesterday in The New England Journal of Medicine (NEJM), I share this review article with title Dying with Dignity in the Intensive Care Unit signed by the doctors Deborah Cook and Graeme Rocker, from Canada.
Traditional goals of Intensive Care are to reduce the mortality and morbidity associated with critical illness, maintain organ function and restore health.
Despite technological advances, death in the ICU remains commomplace.
This review refers to the concept of dignity for patients who will die in the ICU: when the disease wins the battle, when the objectives cannot be achieved or the organic support means losing the human condition, the intensivists have to ensure that our patients die with dignity.
The authors explains the ABCD management in accompaniment in death: attitude, behavior, compassion and dialogue. And this also helps to avoid collateral damages and prevent and resolve conflicts with the families. Although it may seem a paradox, critical care and palliative care in ICUs of the present must co-exist.
In the article there are comments about topics such as analysis of the needs of patients, communication, decision-making, providing prognostic information, making recommendations, providing holistic care, spiritual history and the psychological and moral impact on professionals about living with death daily.
Impressive and required reading.
NEJM say it! (Word of the Lord)