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Decision making in critically ill patients with hematologic malignancy.

¹Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.

The Western Journal of Medicine

|November 1, 1991

Summary

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Hematologic neoplasms are increasingly curable with bone marrow transplantation, but ethical decision-making for critically ill patients is complex. A structured ethical process, prioritizing patient autonomy and clear communication, ensures appropriate critical care decisions.

Area of Science:

Oncology
Medical Ethics
Hematology

Background:

Hematologic neoplasms, once fatal, are now treatable with advanced therapies like bone marrow transplantation.
These life-saving treatments introduce significant ethical challenges in critical care decision-making for patients.

Observation:

Physicians face complex ethical dilemmas when managing critically ill patients with hematologic malignancies.
Factors complicating decisions include rapidly evolving treatments, uncertain prognoses, and the young age of many patients.

Findings:

A decision-making process grounded in general medical ethics can guide critical care for these patients.
This process emphasizes patient autonomy, accurate prognostic information, defined care goals, and open communication.

Keywords:

Death and Euthanasia Professional Patient Relationship

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Implications:

Implementing this ethical framework can lead to appropriate, consistent, and patient-centered critical care decisions.
Improved ethical decision-making supports patients undergoing aggressive hematologic cancer treatments.