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dc.creatorWilson, William C.en
dc.creatorSmedira, Nicholas G.en
dc.creatorFink, Carolen
dc.creatorMcDowell, James A.en
dc.creatorLuce, John M.en
dc.date.accessioned2015-05-05T18:30:22Zen
dc.date.available2015-05-05T18:30:22Zen
dc.date.created1992-02-19en
dc.date.issued1992-02-19en
dc.identifier10.1001/jama.267.7.949en
dc.identifier.bibliographicCitationJAMA. 1992 Feb 19; 267(7): 949-953.en
dc.identifier.issn0098-7484en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Ordering+and+Administration+of+Sedatives+and+Analgesics+during+The+withholding+and+Withdrawal+of+Life+Support+from+Critically+Ill+Patients&title=JAMA.++&volume=267&issue=7&pages=949-953&date=1992&au=Wilson,+William+C.en
dc.identifier.urihttp://dx.doi.org/10.1001/jama.267.7.949en
dc.identifier.urihttp://hdl.handle.net/10822/736029en
dc.description.abstractObjective. -- To determine why and how sedatives and analgesics are ordered and administered during the withholding and withdrawal of life support from critically ill patients. Design. -- Prospective case series. Setting. -- Medical-surgical intensive care units at a county hospital and a university hospital. Patients. -- Consecutive 1-year sample of 22 patients from whom life support was withheld or withdrawn in one intensive care unit at a county hospital and a random sample of 22 similar patients in the intensive care unit in the university hospital over the same period. Main Outcome Measures. -- Physicians and nurses were interviewed to determine their reasons for ordering and administering drugs, and medical records were reviewed to document amounts of drugs ordered and administered. Results. -- Drugs were given to 75% of patients during withholding and withdrawal of life support. Patients who did not receive medication were comatose and considered incapable of benefiting from sedation and analgesia. The median time until death following the initiation of the withholding or withdrawal of life support was 3.5 hours in the patients who received drugs and 1.3 hours in those patients who did not (P, not significant). Physicians ordered drugs to decrease pain in 88% of patients, to decrease anxiety in 85%, to decrease air hunger in 76%, to comfort families in 82%, and to hasten death in 39%; in no instance was hastening death the only reason cited....Conclusions. -- Large doses of sedatives and analgesics were ordered primarily to relieve pain and suffering during the withholding and withdrawal of life support, and death was not hastened by drug administration.en
dc.formatArticleen
dc.languageenen
dc.sourceBRL:KIE/35197en
dc.subjectAllowing to Dieen
dc.subjectAttitudesen
dc.subjectCritically Illen
dc.subjectDeathen
dc.subjectDecision Makingen
dc.subjectDouble Effecten
dc.subjectDrugsen
dc.subjectEvaluationen
dc.subjectEvaluation Studiesen
dc.subjectFamily Membersen
dc.subjectHospitalsen
dc.subjectInstitutional Policiesen
dc.subjectIntensive Care Unitsen
dc.subjectIntentionen
dc.subjectLifeen
dc.subjectMedical Recordsen
dc.subjectMotivationen
dc.subjectNursesen
dc.subjectPainen
dc.subjectPatient Careen
dc.subjectPatientsen
dc.subjectPhysiciansen
dc.subjectPsychological Stressen
dc.subjectRecordsen
dc.subjectSedativesen
dc.subjectSufferingen
dc.subjectSurveyen
dc.subjectTerminal Careen
dc.subjectTerminally Illen
dc.subjectVentilatorsen
dc.titleOrdering and Administration of Sedatives and Analgesics During the Withholding and Withdrawal of Life Support From Critically Ill Patientsen
dc.provenanceDigital citation created by the National Reference Center for Bioethics Literature at Georgetown University for the BIOETHICSLINE database, part of the Kennedy Institute of Ethics' Bioethics Information Retrieval Project funded by the United States National Library of Medicine.en
dc.provenanceDigital citation migrated from OpenText LiveLink Discovery Server database named NBIO hosted by the Bioethics Research Library to the DSpace collection BioethicsLine hosted by Georgetown University.en


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