End-of-Life Issues

  • Paul Ellis Marik


The prime goal of the intensive care unit is to provide temporary physiological support for patients with potentially reversible organ failure and to prevent additional complications while allowing their acute illness to resolve enabling them to return to their previous level of functioning. The care provided in an ICU may, however, be detrimental to patients by providing overly aggressive treatments which may result in increased pain and complications. Ideally, patients should be admitted to an ICU if they are likely to benefit from admission with a decreased risk of death. However, with increasing frequency, patients with end-stage and terminal illnesses are being admitted to the ICU. Angus et al.1 have demonstrated that 60% of all hospital deaths in the United States occur after admission to the ICU, with patients spending on average 8 days in the ICU before their death. Rady and Johnson2 reviewed all hospital deaths over a 2-year period at a teaching hospital in Phoenix, AZ. Of the 252 patients who died in hospital, 196 (78%) were treated and subsequently 165 (65%) died in the ICU.


Palliative Care Hospital Death Advance Care Planning Spiritual Support Family Meeting 
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Pulmonary and Critical Care MedicineEastern Virginia Medical SchoolNorfolkUSA

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