Many patients, especially in high-income countries, end up dying in intensive care units but who should be responsible for the provision of symptom control, end of life care, and communication with these patients and their families?
In the ‘Spotlight’ section of the February issue of The Lancet Respiratory Medicine, specialists from seven countries – Australia, Brazil, France, South Korea, Uganda, UK, USA – answer the question “Should intensive care medics be palliative specialists?”
“Not yet” is the answer from Africa, where there is little justification for spending finite resources on training ICU physicians to become palliative care specialists. However, training intensive care staff in palliative care skill areas, and having clear protocols and pathways to palliative care for those who need, would improve care for patients.
In other countries where resources are not so limited, the answer from commentators is “yes”. In Australia “intensive care clinicians are operating as surrogate palliative care teams” and in France there is “an integrative model that embeds palliative care interventions into daily practice.”
On the journal’s website, in addition to the article, you can also download a podcast, where Judith Nelson from Icahn School of Medicine at Mount Sinai, New York, USA and Prof Élie Azoulay from Hôpital Saint-Louis, Paris, France, discuss the question in more depth.
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