Comfort care: an alternative treatment programme for seriously burned patients

Modern intensive care is capable of keeping burned patients alive for substantial periods of time, despite burn severity with an 'unprecedented' or a marginal probability of survival. When the patient is initially judged to be that severely injured, or when, later in the course of the illness, a point is reached when further curative treatment is clearly futile (Civetta, 1981), the patient and/or the close relatives should be presented with the option of changing the treatment regimen from curative to comfort care. We (Frank and Wachtel, 1984) have described a process for reaching such decisions and a protocol for administering comfort care. During a 5-year period we offered this option to 24 patients. This paper reports the outcome in these cases.