Abstract
Recent medical literature reports increased utilization of the intensive care unit (ICU) at the end of life, even for patients who are considered terminally ill, and the overall ICU adult mortality rate ranges from 10% to 29%. Therefore, ICU nurses require a level of comfort in caring for patients and families at this vulnerable time. At times, ongoing aggressive life-prolonging interventions for a terminally ill patient can create ethical conflicts and moral distress for nurses. This leads to the question: Can this level of treatment be compatible with a "good death?"
Medical recommendations are made based on the patient's goals of care, appropriate treatment options, and associated benefits and burdens. How then should nurses respond when a patient or family does not agree with these medical recommendations? Through a case study, this article explores the moral and ethical conflicts that often occur in the ICU setting at end of life and aid to empower the ICU nurse to care for patients in a way that honors the patient's wishes and maintains a healthy nurse-patient relationship.