Decision-making in ICU:the role of others

• Research type

  Research Study

• Full title

  DECISION-MAKING IN INTENSIVE CARE:THE ROLE OF OTHERS

• IRAS ID

  266092

• Contact name

  Therese Callus

• Contact email

  m.t.callus@reading.ac.uk

• Sponsor organisation

  University of Reading

• Duration of Study in the UK

  1 years, 2 months, 31 days

• Research summary

  Most intensive care patients depend upon others to make critical care decisions on their behalf. Although the Mental Capacity Act 2005 uses the “best interests” test to enable this to happen, very little is understood about how decisions are made in these cases, who has the final say, or the process by which conclusions are reached. Better understanding is needed about whether, and how, clinicians and family members, or carers discuss the patient’s preferences; and indeed, even when they do, whether this is a true reflection of the patient’s perspective. This project offers an opportunity to understand the role of relatives or carers in each decision, especially in respect of potential conflict between decision-makers, and the best ways of supporting and guiding practice.
  This collaborative pilot study will gather and interpret empirical data, linking the practical aspects of clinical decision-making with the development of a normative framework for regulating such decisions.

  Using a questionnaire and follow-up semi-structured interviews, this project will:
  • investigate how the preferences and wishes of the patient are elicited and evaluated within the decision-making process; and
  • critically analyse the involvement and influence of others in the treatment decision-making process.
  • establish the coherence between legal principles and clinical practice on the involvement of others in treatment decisions

  There is an important psychological clinical benefit for patients who survive critical care treatment in knowing how decisions which may continue to affect them were taken. By exploring and articulating the components and, specifically, the actors in a treatment decision, we expect to be able to identify what matters most to the patient when making best interests decision in the challenging environment of an IC ward.

• REC name

  London - City & East Research Ethics Committee

• REC reference

  21/LO/0887

• Date of REC Opinion

  9 Dec 2021

• REC opinion

  Favourable Opinion