From the data reported in table 7 of the paper by Kranidiotis et al, one concludes that family involvement in EOL in the included ICUs is a rare occurrence. As one of the Intensivists of one of these ICUs, I submit that this is not an accurate account. In our unit it is never an option to withdraw, withhold or not escalate therapy without the family being involved in the decision. What is not uncommon is withholding CPR in dying patients without specifically asking the family, because we think that this will not be comprehended by most families and because we consider it unethical to perform CPR on a patient that will surely die (e.g. refractory septic or cardiogenic shock or refractory ARDS). Since data from individual ICUs are not shown, I cannot explain this discrepancy.
George Mixides MD,FRCPC Nicosia General Hospital Intensive Care Unit CYPRUS
Family involvent in EOL
13 January 2011
From the data reported in table 7 of the paper by Kranidiotis et al, one concludes that family involvement in EOL in the included ICUs is a rare occurrence.
As one of the Intensivists of one of these ICUs, I submit that this is not an accurate account. In our unit it is never an option to withdraw, withhold or not escalate therapy without the family being involved in the decision. What is not uncommon is withholding CPR in dying patients without specifically asking the family, because we think that this will not be comprehended by most families and because we consider it unethical to perform CPR on a patient that will surely die (e.g. refractory septic or cardiogenic shock or refractory ARDS).
Since data from individual ICUs are not shown, I cannot explain this discrepancy.
George Mixides MD,FRCPC
Nicosia General Hospital Intensive Care Unit
CYPRUS
Competing interests
No competing interest