End-of-life Care in the Intensive Care Unit

During the past decade, we have seen a steady rise in the percentage of patients who die in intensive care units (ICUs). Often, such deaths occur after prolonged hospital stays with multiple interventions, many of which do not alter the inevitable outcome. The questions of when to stop, and how much is “too much,” arise every day. In 2012, surveys of ICU physicians and nurses provided some insight into clinician perspectives on end-of-life care.

To understand perceptions of appropriateness of ICU care, investigators in Europe and Israel surveyed 1953 critical care clinicians. More than a quarter of respondents reported providing “inappropriate care” — most commonly described as excessive care, given a patient's prognosis. When respondents re…