Ethics/End of Life
Jessica Turnbull, MD, MA (she/her/hers)
Monroe Carell Jr Childrens Hospital at Vanderbilt University Medical Center
Nashville, Tennessee, United States
This session will introduce and explore SCCM's Shared Decision-Making in the ICU policy statement. Nationally recognized experts in critical care and bioethics will provide a broad overview of decision-making in the ICU setting, including how clinician directiveness can be personalized, patient-centered, and ethically justifiable. The SCCM guidelines recommend including nurses and other ICU staff members in the decision-making team with patients and families but there are few published papers on how to accomplish this, and many clinicians are uncomfortable following this recommendation. Speakers will discuss experiences implementing a research-informed institutional policy that requires the inclusion of nursing staff and other non-physician team members in goal-directed care planning. SCCM and the American Thoracic Society recommend the use of informed non-dissent in certain circumstances when making difficult decisions in the ICU, including life-and-death choices, but many clinicians do not fully understand informed non-dissent and lack confidence in using this decision-making model. Speakers will explain informed non-dissent, describe its ethical foundation, and discuss when to use it, including key issues to consider. There will be a panel discussion allowing for questions from attendees.