ICU say the patient is not for intubation and the patient is deteriorating. What would you tell the family?

Question

Accepted Answer

I would arrange to speak to the family in a quiet, private setting with adequate time. I would explain that despite maximal medical treatment and non-invasive ventilation their loved one's lungs are not responding and the condition is continuing to deteriorate, avoiding jargon. I would explain that the intensive care team have carefully assessed whether invasive ventilation would help and unfortunately feel it would not change the overall outcome and could cause more harm or suffering — framed as a joint, proportionate decision rather than abandonment. I would pivot to goals of care: our focus now is to ensure they are comfortable, not distressed, and supported with the best possible care. I would check understanding, allow them to express concerns, and answer questions honestly, closing with reassurance that we will continue to care for the patient closely and support the family throughout. Sometimes the kindest and most appropriate treatment is to prioritise comfort rather than invasive measures unlikely to succeed.

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