A Proposal to Restructure Hospital Care for Dying Patients

Abstract

Data from the recent Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) indicate that the care of hospitalized dying patients continues to be inadequate.¹ We propose a restructuring of hospital care for dying patients through the introduction of a hospice-like alternative-care unit designed to provide palliative care to dying patients who have been transferred from the intensive care unit (ICU). By functionally integrating these two modes of care, the hospital would legitimize palliative care strategies for critically ill patients, help patients and their families clarify goals, and facilitate a process of shared decision making concerning . . .