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Table 1 Challenges and solutions for granting autonomy in open ICUs

From: New perspectives on substituted relational autonomy for shared decision-making in critical care

Challenges Solutions
 • Balancing ethical responsibilities in SDM • Cooperation
• Relational autonomy
 • Preventing burnout • Consultant psychologist
 • Preventing moral distress • Ethical advice
 • Managing interpersonal conflicts in end-of-life SDM • Interdisciplinary meetings
• Staff management and dispositional organization
 • Providing valuable information • Structured communication tools
 • Preventing relatives’ psychological disorders • Physician's social, psychological and ethical skills
• Training
 • Embedded accuracy of the relatives’ predictions • Offering support to relatives