Eight things we would never do regarding end-of-life care in the ICU

  • E. Wesley ElyEmail author
  • Elie Azoulay
  • Charles L. Sprung
What's New in Intensive Care


As intensivists from three distinct regions of the world with different cultural backgrounds, we believe it relevant in this rapidly emerging period of healthcare to share thoughts among clinicians providing end-of-life care in the intensive care unit (ICU). Intimate encounters with patients near the end of their lives [1] form a foundational aspect of our vocation as intensivists. This article is our vision of eight top-tier concepts that should be embraced to usher in the best end-of-life care for all patients. We realize that not everyone will agree with these points and anticipate that our “eight things” will stimulate healthy discussion and debate. Furthermore, there might be caregivers throughout the world dealing with different cultural, legal, political, and ethical preconditions that make implementation of the approach presented within this manuscript difficult in some respects. The joint American Thoracic Society (ATS)/American Association for Critical Care...


Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflicts of interest.

Ethical approval

An approval by an ethics committee was not applicable.


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Critical Illness, Brain Dysfunction, and Survivorship (CIBS) CenterVanderbilt University Medical CenterNashvilleUSA
  2. 2.Veteran’s Affair TN Valley Geriatric Research Education Clinical Center (GRECC)NashvilleUSA
  3. 3.Medical Intensive Care Unit and Department of Biostatistics, APHP, Hôpital Saint-Louis. ECSTRA Team, and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics, Sorbonne Paris Cité, CRESS), INSERMParis Diderot Sorbonne UniversityParisFrance
  4. 4.General Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, Hadassah Medical CenterHebrew University of Jerusalem, Faculty of MedicineJerusalemIsrael

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