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La fin de vie en réanimation, une réalité complexe
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Edité par CCSD ; Elsevier Masson -
International audience. Death is a concrete reality in the intensive care units, a consequence of an intervention-oriented hospital culture. The situation is complex, including “natural” death due to unexpected cardio-respiratory arrest or therapeutic failure, “decided” death in the context of decisions to withhold or withdraw life-sustaining treatments, and death “to the benefit of a third person” in the more specific context of organ procurement. Today, the vast majority of deaths, occurs following a decision to withhold or withdraw life-sustaining treatments. Moreover, organ donation, in the settings of brain death or controlled donation after circulatory death, makes the end of life in intensive care units more challenging. In theory, the legal and ethical framework is clear. In practice, the fitting of this framework to the singularity of the real situations faced is a major issue for the caregivers. The support of relatives and caregivers is essential.
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