Despite advances in the care of the injured patient, 22% of trauma patients admitted to the intensive care unit will die from their injuries. As a majority of these deaths will occur due to withdrawal of care, intensivists should be proficient in their ability to discuss end-of-life care with patients and families. While the use of advance directives to document patients' wishes has increased, their utility is uncertain. We review the effectiveness and obstacles of advance directives.
Keywords: Advance directive; TICU; critical care; end-of-life care; humans; medical ethics; palliative care; trauma; trauma intensive care.