Society guideline links: Intensive care unit ethics

Introduction — This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.

The recommendations in the following guidelines may vary from those that appear in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.

International

●Society of Critical Care Medicine (SCCM): Guidelines for family-centered care in the neonatal, pediatric, and adult ICU (2017)

●SCCM: Policy statement on defining futile and potentially inappropriate interventions (2016)

●American Thoracic Society (ATS)/American Association for Critical Care Nurses (AACN)/American College of Chest Physicians (ACCP)/European Society for Intensive Care Medicine (ESICM)/SCCM: Policy statement on responding to requests for potentially inappropriate treatments in intensive care units (2015)

●ATS/International Society for Heart and Lung Transplantation (ISHLT)/SCCM/Association of Organ and Procurement Organizations (AOPO)/United Network of Organ Sharing (UNOS): Statement on ethical and policy considerations in organ donation after circulatory determination of death (2013)

Canada

●Canadian Association of Critical Care Nurses (CACCN): Position statement on providing end of life care in critical care (2020)

●Choosing Wisely Canada: Don't start or continue life supporting interventions unless they are consistent with the patient's values and realistic goals of care (updated 2020)

●Choosing Wisely Canada: Don't undertake prolonged life-sustaining treatments or escalate to intensive care without establishing prognosis, preferences and goals of care (updated 2020)

●CACCN: Position statement on patient- and family-centred care (2018)

●Canadian Critical Care Society (CCCS) and CACCN: Guidelines for the withdrawal of life-sustaining measures (2016)

United States

●American Thoracic Society (ATS)/American Geriatrics Society (AGS): Policy statement on making medical treatment decisions for unrepresented patients in the ICU (2020)

●American College of Critical Care Medicine (ACCM) and ATS: Policy statement on shared decision making in ICUs (2016)

●ATS: Policy statement on managing conscientious objections in intensive care medicine (2015)

●ATS/American Association for Critical Care Nurses (AACN)/American College of Chest Physicians (ACCP)/European Society for Intensive Care Medicine (ESICM)/Society of Critical Care Medicine (SCCM): Policy statement on responding to requests for potentially inappropriate treatments in intensive care units (2015)

●American College of Chest Physicians (CHEST): Consensus statement on care of the critically ill and injured during pandemics and disasters – Ethical considerations (2014)

●CHEST: Consensus statement on care of the critically ill and injured during pandemics and disasters – Legal preparedness (2014)

●CHEST: Consensus statement on care of the critically ill and injured during pandemics and disasters – System-level planning, coordination, and communication (2014)

●ATS/International Society for Heart and Lung Transplantation (ISHLT)/SCCM/Association of Organ and Procurement Organizations (AOPO)/United Network of Organ Sharing (UNOS): Statement on ethical and policy considerations in organ donation after circulatory determination of death (2013)

●ACCM: Consensus statement on recommendations for end-of-life care in the intensive care unit (2008)

Europe

●American Thoracic Society (ATS)/American Association for Critical Care Nurses (AACN)/American College of Chest Physicians (ACCP)/European Society for Intensive Care Medicine (ESICM)/Society of Critical Care Medicine (SCCM): Policy statement on responding to requests for potentially inappropriate treatments in intensive care units (2015)

United Kingdom

●Choosing Wisely UK: Faculty of Intensive Care Medicine – Life support for patients at high risk of death or severely impaired functional recovery should not be offered. A discussion with patients and their families should focus on the goals of comfort care

●Intensive Care Society (ICS): Statement on ethical considerations for inter-hospital patient transfer & unit capacity (2021)

Australia–New Zealand

●Choosing Wisely Australia: For patients with limited life expectancy (such as advanced cardiac, renal or respiratory failure, metastatic malignancy, third line chemotherapy) ensure patients have a 'goals of care' discussion at or prior to admission to ICU and for patients in ICU who are at high risk for death or severely impaired functional recovery, ensure that alternative care focused predominantly on comfort and dignity is offered to patients and their families (2016)