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Invited Commentary
April 1, 2019

Communication About Treatment Options and Shared Decision Making in the Intensive Care Unit

Author Affiliations
  • 1Clinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven
  • 2Department of Medicine, Yale School of Medicine, New Haven Connecticut
JAMA Intern Med. 2019;179(5):684-685. doi:10.1001/jamainternmed.2019.0034

The intensive care unit (ICU) is a site for frequent and complex medical decision making characterized by considerations to forgo or withdraw life-sustaining therapies. Shared decision making (SDM) is supported by critical care organizations as central to ensuring that care plans reflect patients’ values. Surrogates are called upon to provide information about these values for the many patients who lack decisional capacity. A policy statement by the American College of Critical Care Medicine and American Thoracic Society defined SDM as “a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences.”1[p2]

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