[TJS1-1] Ethical conflicts in ICU Thailand
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ライブ配信】
Ethical conflicts in the ICU setting usually center around the question of how to respond to requests from the patient or the surrogates to administer life-prolonging interventions when clinicians believe those interventions should not be administered. Ethical conflicts facing attending physicians in the ICU in Thailand are not different from other countries. Thai ICU physicians usually take proactive approach to prevent the conflict via deliberate family meetings to prevent breaking down in communication. The clear goals of deliberate family meetings are seeking first to understand the family’s perspective, trying to correct any misperceptions, and share the ICU physician’s perspectives with family members. The consensus among attending consultants are usually achieved before ICU physician leads the discussion with the family members. In difficult cases where there’re different opinions among family members, Thai physicians usually take times to communicate and advocate for the treatment plan they believe is appropriate while listening attentively to each family members to reconcile the different treatment plans. Family members or surrogates are strongly encouraged to spend times with the patient during these processes to help them understand the sufferings that the patient has endured. It has not been a common practice for Thai physicians to bring the ethical conflict cases for review by an interdisciplinary hospital committee or to the court.