Shared Decision Making in ICUs

Publication Date: January 4, 2016

Last Updated: October 5, 2022

Summary

Whether to undergo decompressive hemicraniectomy vs medical treatment in a patient with severe stroke and cerebral swelling
Whether to convert a child from conventional mechanical ventilation to high-frequency ventilation, which might decrease the risk of morbidity or mortality but which would necessitate deep sedation making it impossible for the child and his/her family to communicate
Whether to pursue ongoing weaning efforts at ventilator facility or transition to palliative therapy for a patient with advanced chronic obstructive pulmonary disease who has failed several attempts at ventilator weaning in the ICU
Whether a patient’s quality of life is sufficiently satisfying that he/she would want life-sustaining treatment when a life-threatening event occurs
Whether to attempt resuscitation in the delivery room and provide subsequent neonatal critical care to an extremely premature infant at the threshold of viability
Whether to pursue a risky neurosurgical procedure to attempt to cure a child’s seizures vs continuing to treat with medications that may be impairing his/her performance in school
Whether to proceed with palliative surgical procedures in an infant with complex congenital heart disease