Liver failure, life support, family support, and palliation: an inside story

J Crit Care. 2006 Sep;21(3):250-2. doi: 10.1016/j.jcrc.2005.10.005.


My sister was admitted to the intensive-care-unit (ICU) five months before she died. At the time of admission her life-support wishes were not discussed with her. During her time in the ICU, we, the family, were given hope that she may survive. As with most families, we wanted my sister to live. During her progression from ICU to step-down unit to ward unit, the plan of care was not discussed, and goals were not set. Many medical teams were involved in my sister's care, and many looked at individual body parts instead of the whole person. I am a Registered Nurse at the same hospital where my sister was being cared for. Through many family meetings I was regarded as a medical professional, not as a sister. Knowing the medical system yet going through this as a family member has given me the opportunity to gain insight into what should have happened. If code status had been discussed we would have known my sisters wishes. If relevant literature pertaining to her disease and her slim chance of recovery had been brought to our attention, my sister could have died at home as she wished, and perhaps could have lived her final days in comfort.

MeSH terms

  • Anecdotes as Topic
  • Critical Care / organization & administration*
  • Family / psychology*
  • Hepatic Encephalopathy
  • Humans
  • Life Support Care / organization & administration*
  • Nurses / psychology*
  • Palliative Care / organization & administration*
  • Palliative Care / psychology
  • Patient-Centered Care / organization & administration
  • Professional-Family Relations
  • Quality of Health Care / organization & administration
  • Terminal Care