Prinicples and Practice of Limiting Life-Sustaining Therapies

Andrej Michalsen*, Jan Bakker, Charles L. Sprung, Sabine Reimund, Armand Girbes

*Corresponding author for this work

Research output: Chapter/Conference proceedingChapterAcademic


Decisions regarding the extent of treatment and the application of life-sustaining therapies in intensive care medicine maybe unambiguous at times: the patient will either clearly benefit from such therapies or clearly not. However, for many critically ill or injured patients, the “cutoff” between foreseeable benefit and untoward suffering is not as crystal clear considering scare information and time constraints. Even if the benefits of life-sustaining therapies are undisputed at the time of their implementation, their side effects, such as pain, anxiety, and confusion, as well as unforeseen complications may change the balance of benefits and harm during treatment in an intensive care unit. Therefore, considerable communicational, ethical, and legal challenges may arise as to the potentially irrevocable limitation of life-sustaining therapies. Subsequently, clinicians need to familiarize themselves with the respective reasoning, prerequisites, and practical implementation.

Original languageEnglish
Title of host publicationEthics in Intensive Care Medicine
PublisherSpringer Nature
Number of pages14
ISBN (Electronic)978-3-031-29390-0
ISBN (Print)978-3-031-29389-4, 978-3-031-29392-4
Publication statusE-pub ahead of print - 20 Jul 2023

Publication series

SeriesLessons from the ICU
VolumePart F1176

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.


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