Case 97 - Conductinga family meeting to decide withdrawal of care

Summary

Conducting a family meeting to decide withdrawal of care can be a very difficult process. This chapter presents a case study of a 79-year-old male who was found unconscious in his home by his wife. The intensivist explained to the family that a meaningful outcome would be extremely unlikely given the large stroke, myocardial infarction, and multisystem organ failure. One of the more difficult situations a critical care physician faces is a discussion regarding withdrawal of care or limitation of support with family members whose loved one has developed medical problems from which he or she clearly cannot recover. Entering into discussions with families for these types of problems without prior consideration and expertise can be fraught with difficulty, negative emotions, and may lead to prolongation of suffering of an otherwise dying patient. Most families appreciate an open, honest approach when discussing withdrawal of life supportive measures.