[Decision conflicts with relatives in the intensive care unit].

Area of Science:

• Medical Ethics
• Intensive Care Medicine
• Clinical Communication

Background:

• Conflicts frequently arise in intensive care units (ICUs), particularly concerning life-sustaining treatment decisions.
• These disputes place significant emotional strain on patients' relatives.

Purpose of the Study:

• To review existing studies and recommendations for managing conflict-prone discussions in the ICU.
• To identify strategies for mitigating the emotional impact on families during end-of-life care decisions.

Main Methods:

• A selective literature search of the PubMed database was conducted.
• Analysis of studies evaluating post-traumatic stress in relatives involved in life-limiting treatment decisions.

Main Results:

• Evidence-based recommendations exist for physician communication, attitudes, and contextual factors during therapy discussions.
• Adhering to these recommendations can reduce relatives' emotional stress.
• Clinical ethics committee involvement can prevent conflicts and reduce the duration of unsuccessful life-sustaining measures without impacting mortality.

Conclusions:

• Timely, congruent, and empathic communication in a suitable environment is crucial for preventing ICU conflicts.
• Consultation with clinical ethics committees is recommended for de-escalating disputes and supporting families.