Advanced Search

Home > Journals > Minerva Anestesiologica > Past Issues > Minerva Anestesiologica 2003 April;69(4) > Minerva Anestesiologica 2003 April;69(4):184-9



A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2003 April;69(4):184-9

SMART 2003 - Milan, may 28-30 

When the ICU patient refuses vital supports

Zamperetti N. 1, Piccinni P. 1, Carraro R. 1, Demo P. 1, Marafon S. 1, Ronco C. 2, Dan M. 1

1 Department of Anesthesia and Intensive Care Medicine, San Bortolo Hospital, Vicenza, Italy
2 Deparment of Nephrology, San Bortolo Hospital, Vicenza, Italy

The aim of this paper is to discuss the problem of caring for ICU patients who request forgoing of intensive supports; in particular, evaluating their competence and building effective relationships among the patients themselves, their relatives and the health care team. The histories of 2 adult competent ICU patients 2 asked that vital intervention be forgone are presented, together with the discussion of problems posed by such a request and of possible solutions which respect patients’ autonomy and bystanders needs. These patients were hospitalized in an Italian general 14 bed ICU. The patients’ request were weighted against their prognosis and their view of life, in order to evaluate their reliability. Also the refusal of either treatment or outcome was evaluated, in order to effectively safeguard the patients’ interests. The request of one patient was satisfied and he was allowed to die, after all the involved people had understood and accepted the final decision. The second patient, who was somehow forced to undergo intensive treatment, is alive and satisfied with having been cured.In Italy too, autonomy is an increasingly applied principle in end-of-life decisions in ICUs. It is usually tempered by a consideration about the patients’ best interest as perceived by involved bystanders.

language: English


top of page