What are the best interests of terminally ill patients in intensive care who lack capacity to decide for themselves? At what stage should their care be considered futile? Although this important question arises at a crucial moment in a person’s life, there is room for a considerable range of responses. What is the relevance, for example, of a belief in the sanctity of life, the likelihood that the patient will get better, the suffering and indignity caused by treatment, the wishes of patients and their relatives, or the interests of other needy patients? In the past, these difficulties were often quietly settled by doctors, guided, when possible, by patients and by their relatives. Now, when disagreement leads to dispute, the courts have been required to provide solutions of their own. In doing so, they grapple with the balance between the patient’s subjective beliefs and wishes (assisted by their relatives), and doctors’ experience of the challenges further treatment may cause the patient. We consider how the law and clinical practice have evolved and the framework of procedures and values within which these troubling cases should be considered.
IMPACT OF PATIENT- AND FAMILY-CENTRED CARE MEETINGS ON INTENSIVE CARE RESOURCE UTILISATION IN TERMINALLY ILL PATIENTS: A SINGLE-CENTRE RETROSPECTIVE OBSERVATIONAL STUDY IN TAIWAN
