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Ethics of Outbreaks Position Statement. Part 2

Family-Centered Care

Papadimos, Thomas J., MD, MPH1,2; Marcolini, Evadne G., MD3; Hadian, Mehrnaz, MD4; Hardart, George E., MD5; Ward, Nicholas, MD6; Levy, Mitchell M., MD7; Stawicki, Stanislaw P., MD, MBA8; Davidson, Judy E., DNP, RN9

doi: 10.1097/CCM.0000000000003363
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Objectives: Continue the dialogue presented in Ethics of Outbreaks Position Statement. Part 1, with a focus on strategies for provision of family-centered care in critical illness during Pubic Health Emergency of International Concern.

Design: Development of a Society of Critical Care Medicine position statement using literature review, expert consensus from the Society of Critical Care Medicine Ethics Committee. A family member of a patient who was critically ill during a natural disaster served on the writing panel and provided validation from a family perspective to the recommendations.

Setting: Provision of family-centered care and support for patients who are critically ill or who have the potential of becoming critically ill, and their families, during a Pubic Health Emergency of International Concern.

Interventions: Communication; family support.

Measurements and Main Results: Family-centered interventions during a Pubic Health Emergency of International Concern include understanding how crisis standards may affect regional and local traditions. Transparently communicate changes in decision-making authority and uncertainty regarding treatments and outcomes to the family and community. Assess family coping, increase family communication and support, and guide families regarding possible engagement strategies during crisis. Prepare the public to accept survivors returning to the community.

1Division of Critical Care, Department of Anesthesiology, University of Toledo College of Medicine and Life Sciences, Toledo, OH.

22nd Department of Anesthesiology, University of Athens, Athens, Greece.

3Department of Emergency Medicine, Critical Care Education, Neurological Critical Care Fellowship, University of Vermont Larner College of Medicine, Burlington, VT.

4Department of Medicine, Institute for Public Information in Research and Education in Critical Care Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.

5Division of Pediatric Critical Care, Department of Pediatrics, Center for Bioethics, Program in Women and Children’s Bioethics, Columbia University College of Physicians and Surgeons, New York, NY.

6Division of Critical Care, Pulmonary, and Sleep Medicine, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI.

7Division of Critical Care, Pulmonary, and Sleep Medicine, Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI.

8Department of Research and Innovation and Department of Surgery, St. Luke’s University Heath Network, Bethlehem, PA.

9Education, Development, and Research, University of California San Diego Health System, San Diego, CA.

The authors have disclosed that they do not have any potential conflicts of interest.

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