[Dying in the intensive care unit]

Intensive care medicine symbolizes a form of medicine that seeks to prevent or overcome illness and life-threatening situations in order to enable a life that is acceptable to the patient. Despite the curative goal, dying and death are unavoidable. For ethically founded intensive care medicine, treatment goals must be agreed upon. The use of all resources is justified by their alignment with these goals and their desire for the patient. The indication and patient consent must be continually reviewed. If the goals are no longer achievable or desired by the patient, dying must be permitted. Then the steps for withholding treatment and palliative care must be organized, and end-of-life-care must be facilitated by relatives and the team. These decisions require not only professional but also communicative competence. Advance directives and ethics advice can be helpful. A case study illustrates this.