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]
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Fried TR. Communication About Treatment Options and Shared Decision Making in the Intensive Care Unit. JAMA Intern Med. 2019;179(5):684–685. doi:10.1001/jamainternmed.2019.0034
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: