Consent and agreement

Many procedures in intensive care are invasive or involve significant risk. The patient is often not competent to consent for such treatment and, in many countries, surrogate consent or assent cannot be legally given by the next-of-kin. It is important that the risks and benefits of the procedure are explained to the next-of-kin and that this discussion is documented in the case records. For major decisions, particularly those involving withdrawal or withholding of life-prolonging treatments, the patient should ideally be involved in discussions. If not feasible, relatives should be asked to give their view of what the patient would want in this situation.

Research presents consent problems in the critically ill and requires close ethical committee supervision.

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