End-of-life care and blood purification therapy in our ICU

Abstract

In our ICU, we hold multi-disciplinary conferences every morning, confirm and share our patient’s pathology and treatment policy, and conduct multi-disciplinary team medical care. In recent years, as end-of-life care has attracted more attention from society, various organizations and academic societies have issued guidelines and proposals for end-of-life care. Among the severely ill patients treated in the ICU, there are cases that are judged to be “terminal,” with no prospect of survival, despite appropriate treatment. For these cases, we refer to guidelines and recommendations for end-of-life care, and hold thorough discussions in our multi-disciplinary team conferences based on the patient’s pathology and background to make careful and objective decisions about treatment. In addition, there are many cases in which the patients are unable to make decisions by themselves regarding their treatment, and must entrust decision-making to a family member or the like. For patients who are indicated for blood purification therapy, we “forgo” blood purification therapy after sufficient discussion and consensus building with them, their family or the like. The current novel coronavirus pandemic has created new problems, such as reduced opportunities and time for discussion with their family or others due to visitation restrictions.