Clinical Momentum as One Reason Dying Patients Are Underserved in Acute Care Settings

"Clinical momentum" refers to the curious expansion of interventions applied to patients in the intensive care unit (ICU) without pause or design, leading to extensions of care that can violate patient wishes and distress clinicians. In this article, clinical momentum is placed in a wider...

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Bibliographic Details
Published inAMA journal of ethics Vol. 20; no. 8; p. E732
Main Author Chapple, Helen Stanton
Format Journal Article
LanguageEnglish
Published United States 01.08.2018
Subjects
Adult
Aged
Aged, 80 and over
Critical Care - ethics
Critical Care - psychology
Decision Making
Female
Humans
Male
Middle Aged
Patient Preference - psychology
Right to Die
Terminal Care - ethics
Terminal Care - psychology
Treatment Refusal - ethics
Treatment Refusal - psychology
United States
United States
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Summary:"Clinical momentum" refers to the curious expansion of interventions applied to patients in the intensive care unit (ICU) without pause or design, leading to extensions of care that can violate patient wishes and distress clinicians. In this article, clinical momentum is placed in a wider context that includes ritual, reimbursement patterns, and actor network theory. These contextual features help motivate understanding of one way in which dying patients are underserved in intensive care settings. Suggestions are made for clinician interaction with families under these circumstances.
ISSN:2376-6980
DOI:10.1001/amajethics.2018.732