The End-of-Life Care in the Intensive Care Unit

Jae Young Moon; Yong Sup Shin

doi:10.4266/kjccm.2013.28.3.163

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Review Article The End-of-Life Care in the Intensive Care Unit: Jae Young Moon, Yong Sup Shin; DOI: https://doi.org/10.4266/kjccm.2013.28.3.163

¹Division of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Daejeon, Korea.
²Department of Anesthesiology and Pain Medicine, Chungnam National University College of Medicine, Daejeon, Korea. ysshin@cnu.ac.kr

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Abstract

The intensive care units (ICUs) provide the best possible medical care to help critically ill patients survive acute threats to their lives. At the same time, the ICU is also the most common place to die. Thus the ICU clinicians should be competent in all aspects for end-of-life (EOL) care. The quality of EOL care in Korean ICUs do not ensure ICU patient's autonomy and dignity at their end-of-life. For examples, several studies present that do-not-resuscitate (DNR) orders are only initiated when the patient's death in imminent. To improve understanding EOL care of terminally ill patients, we summarize 'Recommendations for EOL care in the ICU by the American College of Critical Care Medicine' and 'Consensus guidelines to withdrawing life-sustaining therapies endorsed by Korean Academy of Medical Science'. EOL care will be emerging as a comprehensive area of expertise in Korean ICUs. The ICU clinicians must strive to find the barriers for EOL care in the ICU and develop their processes to improve the care of EOL.

Keywords: autonomy;do-not-resuscitate order;end-of-life care;intensive care unit;palliative care;patient-centered care

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