Treatment and Support for Adults at the End of Life in Intensive Care : A Recommendation by the Ethics Section of DIVI and the German Society for Palliative Medicine. Part 1: Key Aspects of End-of-Life Care and Dying in Intensive Care. Part 2: Therapeutic Measures and Support at the End of Life in Intensive Care

The primary goal of intensive care medicine is to overcome a critical phase of illness using all available means and to enable patients to survive and return to an independent life without intensive care. However, this therapeutic goal cannot always be achieved. The possibility of death, the need to alleviate suffering, and respect for the end of life make it necessary to integrate palliative approaches into intensive care medicine. Supporting seriously ill and dying patients and their relatives in intensive care units requires an attitude that holistically recognizes and respects their individuality and is shared by the entire team. In addition to recognizing life and death, reliable structures, clear agreements, and palliative care skills among the respective professional groups are necessary. When implementing these approaches, it is important to remain within the framework of legal requirements and to take the wishes of those affected into account. In addition to the relevant professional expertise, the most important tool is respectful and clear communication with all those involved and affected. Help should be available at all times in cases of uncertainty regarding ethical and palliative issues, as well as in cases of psychological stress.