[Interdisciplinary ethics consultation on the surgical intensive care unit]

Area of Science:

• Intensive care medicine
• Medical ethics
• Clinical decision support

Context:

• Ethics consultation (EC) in intensive care units (ICUs) is typically initiated based on subjective clinical assessments.
• Objective criteria are needed to standardize the initiation of EC.
• The Sequential Organ Failure Assessment (SOFA) score is a potential tool for objectifying EC initiation.

Purpose:

• To objectify the initiation of interdisciplinary ethics consultations (EC) in the ICU using the SOFA score.
• To evaluate the impact of EC on the clinical course of critically ill patients.
• To compare outcomes of patients receiving EC versus those who did not.

Summary:

• A two-year study analyzed 764 ICU patients, with 52 receiving EC.
• EC patients were older, had longer hospital stays, and higher mortality than non-EC patients.
• The SOFA score was significantly higher at the time of EC compared to ICU admission, supporting its use as an objective indicator.

Impact:

• Interdisciplinary EC aids in treatment maximization/limitation decisions for critically ill patients.
• EC facilitates improved end-of-life care and dignified dying.
• Using the SOFA score to guide EC indication can enhance clinical decision-making and patient care.