Speaking for the dying: life-and-death decisions in intensive care

Holding life and death in their hands

Is this for me?

The intensive care unit. Personnel ; Rhythms ; Economics

Actors. Patients ; Friends, family, and significant others ; Health care professionals

Decisions. Informed consent ; Venues ; Affect ; Conflict

Prognosis. Evidence ; Timing ; Mixed messages ; Negotiation ; Accuracy ; Prognostic framing

Decision-making scripts. The legal script ; Cognitive scripts ; Conflicts of interest ; Law at the bedside

Improvisation: decisions in the real world. The patient should decide ; Reprising patient instructions ; Standing in the patient's shoes ; Beneficence ; It's God's decision ; What we want ; Denial, opting out

Making a difference? The role of physicians ; Opting for a trajectory ; Outcomes ; I thought the law would take care of this ; Does any of this matter?

The end. Implications ; Before it's too late ; When it's too late ; When "this" happens to me.

Holding life and death in their hands

The intensive care unit

Actors

Decisions

Prognosis

Decision-making scripts

Improvisation

Making a difference?

The end. Implications

Appendix A: The research

Appendix B.1: Patient occupation

Appendix B.2: Patient age, gender and marital status

Appendix B.3: Location and purpose of observed meetings

Appendix C: Relationship between multiple trajectories traversed

Appendix D: Decision trajectory by patient and surrogate characteristics

Appendix E: Advance-directive status and aspects of the decision-making process, outcome, and impact.

Holding life and death in their hands. Is this for me?

The intensive care unit. Personnel ; Rhythms ; Economics

Actors. Patients ; Friends, family, and significant others ; Health care professionals

Decisions. Informed consent ; Venues ; Affect ; Conflict

Prognosis. Evidence ; Timing ; Mixed messages ; Negotiation ; Accuracy ; Prognostic framing

Decision-making scripts. The legal script ; Cognitive scripts ; Conflicts of interest ; Law at the bedside

Improvisation: decisions in the real world. The patient should decide ; Reprising patient instructions ; Standing in the patient's shoes ; Beneficence ; It's God's decision ; What we want ; Denial, opting out

Making a difference? The role of physicians ; Opting for a trajectory ; Outcomes ; I thought the law would take care of this ; Does any of this matter?

The end. Implications ; Before it's too late ; When it's too late ; When "this" happens to me.