Intensive Care Medicine

, Volume 46, Issue 1, pp 107–109 | Cite as

Financial stress after critical illness: an unintended consequence of high-intensity care

  • Nita Khandelwal
  • Peter May
  • J. Randall CurtisEmail author
Less is more in Intensive Care

For patients with chronic, life-limiting illness, deterioration in health can result in admission to the ICU, with the goal of restoration of health back to or near their prior quality of life. However, such patients may also receive costly, high-intensity care that they find burdensome and inconsistent with their values and goals [1]. Further, this high-intensity care may be ineffective [2], and place unnecessary psychological and physical burden on patients and their family [3]. For patients who survive, they may be at risk for experiencing an outcome that they consider to be worse than death, such as permanently needing help with activities of daily living like toileting or bathing [4]. These unfortunate realities raise the question of whether there is an important opportunity to apply the principle of “less is more” in the care of some patients with chronic, life-limiting illness.

As intensivists, we aim to provide goal-concordant care by informing patients and family members of...


Compliance with ethical standards

Conflicts of interest

The authors have no conflicts of interest.


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Copyright information

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

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain Medicine, Harborview Medical CenterUniversity of WashingtonSeattleUSA
  2. 2.Cambia Palliative Care Center of Excellence, Harborview Medical CenterUniversity of WashingtonSeattleUSA
  3. 3.Centre for Health Policy and ManagementTrinity College DublinDublinIreland
  4. 4.The Irish Longitudinal Study on Ageing (TILDA)Trinity College DublinDublinIreland
  5. 5.Division of Pulmonary, Critical Care, & Sleep Medicine, Department of Medicine, Harborview Medical CenterUniversity of WashingtonSeattleUSA

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