Perspectives on care at the close of life. Management of dyspnea in patients with far-advanced lung disease: "once I lose it, it's kind of hard to catch it... "J M Luce
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, 1001 Potrero Ave, Room 5K1, San Francisco, CA 94110, USA
JAMA 285:1331-7. 2001
..Physicians should encourage end-stage lung disease patients and their families to discuss issues such as hospitalization and mechanical ventilation, to prepare advance directives, and to participate in a plan to manage their dyspnea...
- Can health care costs be reduced by limiting intensive care at the end of life?
John M Luce
Department of Medicine, University of California, San Francisco, San Francisco, California, USA
Am J Respir Crit Care Med 165:750-4. 2002
- Corticosteroids in ARDS. An evidence-based review
John M Luce
Department of Medicine and Anesthesia, University of California, Medical Surgical Intensive Care Unit, San Francisco General Hospital, San Francisco, California, USA
Crit Care Clin 18:79-89, vii. 2002
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Hope, truth, and preparing for death: perspectives of surrogate decision makersLatifat Apatira
University of California, San Francisco, and San Francisco General Hospital, San Francisco, California 94143, USA
Ann Intern Med 149:861-8. 2008
..Although many physicians worry that openly discussing a poor prognosis will cause patients and families to lose hope, surrogate decision makers' perspectives on this topic are largely unknown...
A history of resolving conflicts over end-of-life care in intensive care units in the United StatesJohn M Luce
Department of Medicine and Anesthesia, University of California, San Francisco, and San Francisco General Hospital, San Francisco, CA, USA
Crit Care Med 38:1623-9. 2010
..To present a case of conflict over end-of-life care in the intensive care unit (ICU) and to describe how such conflicts have been resolved in the United States since the inception of ICUs...
- Life support for patients without a surrogate decision maker: who decides?
Douglas B White
University of California, San Francisco, and San Francisco General Hospital, San Francisco, California 94143 0903, USA
Ann Intern Med 147:34-40. 2007
..Physicians in intensive care units have withdrawn life support in incapacitated patients who lack surrogate decision makers and advance directives, yet little is known about how often this occurs or under what circumstances...
- End-of-life decision making in the intensive care unit
John M Luce
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, 1001 Potrero Avenue, Room 5K1, San Francisco, CA 94110, USA
Am J Respir Crit Care Med 182:6-11. 2010
..Ethics committees actually are allowed to make such decisions in one state when disagreements cannot be resolved otherwise...
- Decisions to limit life-sustaining treatment for critically ill patients who lack both decision-making capacity and surrogate decision-makers
Douglas B White
Division of Pulmonary and Critical Care Medicine, University of California, San Francisco School of Medicine, San Francisco, CA, USA
Crit Care Med 34:2053-9. 2006
..Decisions to limit life support were generally made by physicians without judicial or institutional review. Further research and debate are needed to develop optimal decision-making strategies for these difficult cases...
- A history of ethics and law in the intensive care unit
John M Luce
Department of Medicine, University of California, 505 Parnassus Avenue, San Francisco, CA 94143, USA
Crit Care Clin 25:221-37, x. 2009
..Advancement of the ethical principle of respect for patient autonomy in ICUs increasingly is in conflict with physicians' concern about their own prerogatives and with the just distribution of medical resources...
- Are physicians' recommendations to limit life support beneficial or burdensome? Bringing empirical data to the debate
Douglas B White
Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, CA 94143, USA
Am J Respir Crit Care Med 180:320-5. 2009
..Although there is a growing belief that physicians should routinely provide a recommendation to surrogates during deliberations about withdrawing life support, there is a paucity of empirical data on surrogates' perspectives on this topic...
- Surrogate decision-makers' perspectives on discussing prognosis in the face of uncertainty
Leah R Evans
Division of Pulmonary and Critical Care Medicine, University of California School of Medicine, San Francisco, California 94143 0903, USA
Am J Respir Crit Care Med 179:48-53. 2009
..Many physicians are reluctant to discuss a patient's prognosis when there is significant prognostic uncertainty...
- The pressure to withhold or withdraw life-sustaining therapy from critically ill patients in the United States
John M Luce
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, 1001 Potrero Avenue, Room 5 K1, San Francisco, CA 94110, USA
Am J Respir Crit Care Med 175:1104-8. 2007
..The pressure also may damage communications and cause resentment. If communications cannot be improved, and if the pressure cannot be relieved, a due process approach to conflict resolution that involves other parties may be required...
- Who should receive life support during a public health emergency? Using ethical principles to improve allocation decisions
Douglas B White
Program in Medical Ethics, School of Medicine, University of California San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143 0903, USA
Ann Intern Med 150:132-8. 2009
..We discuss strategies to engage the public in setting the priorities that will guide allocation of scarce life-sustaining treatments during a public health emergency...
- Intrinsic positive end-expiratory pressure in Acute Respiratory Distress Syndrome (ARDS) Network subjects
Catherine Lee Hough
Division of Pulmonary and Critical Care Medicine, Department of Medicine at the University of Washington, Seattle, WA, USA
Crit Care Med 33:527-32. 2005
..It is unlikely that the difference in intrinsic PEEP between the study groups was clinically important in the ARDS Network study of low tidal volume ventilation...
- Doubt and belief in physicians' ability to prognosticate during critical illness: the perspective of surrogate decision makers
Lucas S Zier
UC Berkeley UC San Francisco Joint Medical Program, School of Public Health, University of California, Berkeley, CA, USA
Crit Care Med 36:2341-7. 2008
..We sought to determine: 1) surrogates' beliefs about whether physicians can accurately prognosticate for critically ill patients; and 2) how individuals use prognostic information in their role as surrogate decision-makers...
- Research ethics and consent in the intensive care unit
John M Luce
Medical and Surgical Intensive Care Units, San Francisco General Hospital, University of California, San Francisco, California 94110, USA
Curr Opin Crit Care 9:540-4. 2003
..The subject of research ethics and informed consent in the ICU has recently received unprecedented attention during the past year, the reasons for which are reviewed herein...
- Informed consent for clinical research involving patients with chest disease in the United States
John M Luce
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA
Chest 135:1061-8. 2009
..Consent can be deferred or waived for emergency research only rarely in the United States, in contrast to other countries...
- Protecting subjects with decisional impairment in research: the need for a multifaceted approach
Henry J Silverman
Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
Am J Respir Crit Care Med 169:10-4. 2004
- Clinical implementation of the ARDS network protocol is associated with reduced hospital mortality compared with historical controls
Richard H Kallet
Department of Anesthesia, University of California, San Francisco at San Francisco General Hospital, California, USA
Crit Care Med 33:925-9. 2005
..CONCLUSION: Adoption of the ARDS Network protocol for routine ventilator management of acute lung injury/acute respiratory distress syndrome patients was associated with a lower mortality compared with recent historical controls...
- Palliative care in the intensive care unit: barriers, advances, and unmet needs
Douglas B White
Division of Pulmonary and Critical Care Medicine and Program in Medical Ethics, University of California, 521 Parnassus Avenue, Suite C 126, San Francisco, CA 94143 0903, USA
Crit Care Clin 20:329-43, vii. 2004
..As ongoing research efforts yield new insights, our ability to practice evidence-based palliative care in the ICU will grow, and new avenues for improvement will become evident...
- Detection of patient-ventilator asynchrony during low tidal volume ventilation, using ventilator waveform graphics
Richard H Kallet
National Heart, Lung, and Blood Institute's ARDS Network, University of California, San Francisco General Hospital, 94110, USA
Respir Care 47:183-5. 2002
- Medical malpractice and the chest physician
John M Luce
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, San Francisco, CA 94110, USA
Chest 134:1044-50. 2008
..And by stressing individual accountability, it conflicts with a systems-oriented approach to reducing medical errors...
- Intensive care of human immunodeficiency virus-infected patients during the era of highly active antiretroviral therapy
Alison Morris
Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA
Am J Respir Crit Care Med 166:262-7. 2002
..These patients may have an improved survival because of effects of therapy on variables such as likelihood of non-AIDS-associated admission diagnoses and serum albumin levels...
- Is the concept of informed consent applicable to clinical research involving critically ill patients?
John M Luce
San Francisco General Hospital, CA, USA
Crit Care Med 31:S153-60. 2003
..Stronger research oversight may be as important as informed consent in protecting patient welfare...
- Three patients who asked that life support be withheld or withdrawn in the surgical intensive care unit
John M Luce
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, USA
Crit Care Med 30:775-80. 2002
..CONCLUSIONS: Patients' wishes change and are difficult to know, and even when they are known, physicians may have difficulty honoring them. Nevertheless, patient autonomy should be respected whenever possible in the intensive care unit...
- Soluble intercellular adhesion molecule-1 and clinical outcomes in patients with acute lung injury
Carolyn S Calfee
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143 0111, USA
Intensive Care Med 35:248-57. 2009
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- Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine
Robert D Truog
Harvard Medical School and Children s Hospital, Boston, MA, USA
Crit Care Med 36:953-63. 2008
..S. perspective. They do not use an evidence grading system because most of the recommendations are based on ethical and legal principles that are not derived from empirically based evidence...
- Quality indicators for end-of-life care in the intensive care unit
Ellen B Clarke
Center for Applied Ethics and Professional Practice, University of Washington, Seattle, USA
Crit Care Med 31:2255-62. 2003
..Once validated, these indicators might be used to improve the quality of EOLC by serving as the components of an internal or external audit evaluating EOLC continuous quality improvement efforts in intensive care unit settings...
- A legally sanctioned process for resolving conflicts about treatment considered medically inappropriate
John M Luce
Crit Care Med 35:1419-20. 2007
- Ethics consultation in the intensive care unit
Douglas B White
JAMA 290:3191; author reply 3191-2. 2003
- A content analysis of forms, guidelines, and other materials documenting end-of-life care in intensive care units
Ellen B Clarke
Department of Critical Care Medicine, Brown University, Rhode Island Hospital, Providence, RI, USA
J Crit Care 19:108-17. 2004
..A second purpose was to determine how these materials might be modified to include more EOLC content and used to trigger clinical behaviors that might improve the quality of EOLC...
- Rationing critical care beds: a systematic review
Tasnim Sinuff
Crit Care Med 32:1588-97. 2004
..Critical care bed rationing requires further investigation...
- International differences in end-of-life attitudes in the intensive care unit: results of a survey
Arino Yaguchi
Department of Intensive Care Medicine, Erasme Hospital, Free University of Brussels, Brussels, Belgium
Arch Intern Med 165:1970-5. 2005
..Substantial work remains if an international consensus on these issues is to be reached...
- The imperfect diagnosis of acute respiratory distress syndrome
John M Luce
Crit Care Med 33:2419-20. 2005
- Reasons for nonenrollment in a clinical trial of acute lung injury
Andrea E Glassberg
The Permanente Medical Group, 39400 Paseo Padre Parkway, Fremont, CA 94538, USA
Chest 134:719-23. 2008
..We examined the reasons for nonenrollment and the impact of the availability of a surrogate decision maker on critical care clinical trials enrollment...
- Acknowledging our mistakes
John M Luce
Crit Care Med 34:1575-6. 2006
- Rationing in the intensive care unit
Robert D Truog
Professor of Medical Ethics and Anesthesia (Pediatrics, Harvard Medical School, Senior Associate in Critical Care Medicine, Children's Hospital, Boston, MA, USA
Crit Care Med 34:958-63; quiz 971. 2006
..Additional work is needed to elucidate how both empirical evidence and ethical analysis can further inform the rationing decisions that arise in the taxonomy described here...
