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End-of-life decision-making in the intensive care unit (ICU) is one of the most intricate and ethically charged areas in modern healthcare. Decisions to transition from active medical interventions to the implementation of end-of-life (EOL) practices and providing palliative care often lead to a complex interplay of dynamics, particularly between physicians, families, and nursing staff. This chapter, which integrates theoretical concepts with practical considerations, offers a comprehensive understanding of the interpersonal and systemic challenges that shape the EOL decision-making dynamics. Such knowledge, apart from its academic value, can also support clinicians, policymakers, and researchers who aim to contribute to more informed, ethically robust, and high-quality EOL care.

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The Complex Dynamics of Decision-Making at the End of Life in the Intensive Care Unit

  • 章节

  • 发表日期：

    2025年

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  • Spiros Georgakis,
  • Mary Gouva,
  • Vasilios Koulouras

摘要

End-of-life decision-making in the intensive care unit (ICU) is one of the most intricate and ethically charged areas in modern healthcare. Decisions to transition from active medical interventions to the implementation of end-of-life (EOL) practices and providing palliative care often lead to a complex interplay of dynamics, particularly between physicians, families, and nursing staff. This chapter, which integrates theoretical concepts with practical considerations, offers a comprehensive understanding of the interpersonal and systemic challenges that shape the EOL decision-making dynamics. Such knowledge, apart from its academic value, can also support clinicians, policymakers, and researchers who aim to contribute to more informed, ethically robust, and high-quality EOL care.