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Doctors Reveal ICU Patients Receive Futile Care

By Cheri Cheng | Update Date: Sep 11, 2013 04:39 PM EDT

When it comes to fighting diseases, getting proper treatment from doctors and hospitals is very important. Even though medicines and medical equipment have improved survival rates, not all patients receive the right kind of care. In a newly released report this week, experts concluded that cancer care is in crisis, citing that some people are not receiving the best treatment possible for their conditions. However, in some cases, treatment can become futile once the patients are close to death. In a new study, researchers found that a lot of patients in intensive care units (ICU) are getting futile treatment.

"Many physicians find that the provision of futile care is not only contradictory to their professional responsibility, but harmful to patients," the director of the UCLA (University of California Los Angeles) Healthcare Ethics Center at the David Geffen School of Medicine and senior author of the study, Dr. Neil Wenger said according to Reuters. "The biggest issue, more important than the cost issue, is the use of highly advanced medical care that was designed to rescue people that instead gets used to prolong the dying process."

For this study, the research team enlisted the help of 13 ICU doctors in defining the term, futile treatment. The team then questioned the attending critical care specialist at five ICUS each day for three months. The surveys recorded how many patients received futile treatment based on the team's definition. Over the course of the study, the researchers interviewed 36 doctors who tended to 1,136 patients. There was an average of six assessments for each patient.

The researchers discovered that 11 percent, equivalent to 123, of the patients received futile treatment. The team also found that another 8.6 percent, or 98 patients, were most likely getting futile treatment. Based from the data, the team calculated that 84 of the patients who received futile treatment died before discharge. Another 24 died during their stay in the ICU. The remaining patients that received futile treatment remained in "severely compromised" states.

Despite this finding, the researchers admitted that futile treatment is hard to define. Since doctors and relatives of the patients might have different understanding of what futile treatment is, changing how patients are cared for in ICUs will be difficult. The researchers stated that what could be important is an increased in communication between ICU patients who can still talk and doctors in deciding what kind of care they want by the time their life ends.

"It's a very complex process making decisions for very ill patients who are on the brink of death," Wenger said. "The main message is that early discussions and advance planning are absolutely critical."

The study was published in JAMA Internal Medicine

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