Thread by @WelshGasDoc

Intensive Care provides organ support while a reversible process is treated. There is no benefit of intensive care in the context of an irreversible pathology.

For Intensive Care to work, you need both a reversible disease and a patient with the reserve to respond to treatment.

Intensive Care is a burdomsome treatment. It is rare for patients to come out of it unscathed (either physically or psychologically). It is not “sleeping on a breathing machine” - at a cellular level, patients are running consecutive marathons.

Without Intensive Care, some people will die. When it’s clear that either the disease process is irreversible, or the patient doesn’t have the capacity to survive, then that’s when withdrawal of life prolonging therapies is considered.

This is NOT euthanasia (as we don’t give something with the sole intention of bringing about death). It is allowing patients to pass naturally with comfort and dignity...and it is NOT “pulling the plug”.

As some patients may suffer respiratory distress without mechanical support, and may be in severe pain, then certain medications are given to alleviate these distressing symptoms. This is the basis of palliative care on Critical Care.

Dragging patients through, for a few more days, weeks or months, while the underlying process is continuing is cruel. Continuing treatment in the face of the utterly untreatable is futile.

And I know this all sounds black and white, but it isn’t. So much thought, consideration and deliberation goes into these decisions. These decisions aren’t made alone, a whole team (Drs being only one part of it) are involved, and all options are considered fully.

However, even if YOUR disease process is incompatible with living; there is a possibility that you can still help others after your death. Make sure your wishes about organ/tissue donation are known...consider signing the #OrganDonation register.