Ethics consultations in the intensive care unit (ICU) reduced duration of ICU stay and time on aggressive, life sustaining treatments with no change in overall mortality
QUESTION: Do ethics consultations in the intensive care unit (ICU) reduce length of ICU stay and aggressive, life sustaining treatments in patients who ultimately die before discharge?
Design
Randomised {allocation concealed}*, unblinded, controlled trial with follow up to hospital discharge.
Setting
Medical and paediatric ICUs in a university medical centre in San Diego, California, USA.
Patients
74 patients identified by nurses when value based treatment conflicts arose during the course of treatment. Types of conflict included disputes with family members or among the healthcare team about changes to patient resuscitation status, intubation or extubation, or the use of aggressive life saving measures. 70 patients (95%) were included in the intention to treat analysis (mean age 49 y, 61% men).
Intervention
37 patients were allocated to the intervention, in which the responsible physician was offered an ethics consultation to be led by 1 of 4 members of the ethics consultation service who had qualifications at …
