Death and Dying in the ICU: Personal Reflection of 30 Years' Experience

Objective: To describe individual perspective over similar to 30 years in a mixed Cardiac and General ICU, which includes the State Trauma Center, National Cardiac Transplant and Complex Cardiac Center, Extracorporeal Membrane Oxygenation Center, Home Ventilation Program, and the major PICU for 6 million people. Data Sources: Personal experience and reflection, complemented by published local data. Study Selection: Illustrative publications of local other data. Data Synthesis: Narrative, experiential reflection. Conclusions: I have agreed to palliative care in many patients of diverse religious, social, and cultural beliefs while providing longterm ICU care to other patients with similar illnesses and prognosis. This can occur when family meetings allow honest and direct conversation with respect for differences; as a clinician, I listen to a family and understand their perspectives and together develop a clear and agreed plan.