End of life care in the ICU: current practice and future hopes

Dying well in the United States is not the standard of care, particularly in critical care units. A number of factors contribute to this clinical deficiency, yet opportunities and strategies to correct the deficiencies are evident through the work of end-of-life advocates and clinical pioneers in nursing and medicine. The purpose of this paper is to describe barriers to optimal end of life care in the ICU and to recommend strategies for making improvements. Ideally, all persons who are not expected to survive a critical illness will experience compassionate, comprehensive, patient and family-focused attention directed at allowing the patient to die well.