Compassionate Care for the Critically Ill
Harborview's J. Randall Curtis honored for improving care of the dying
As critically ill patients near the end of life, their families often struggle with painful emotions as they grapple with medical care decisions. Families frequently have to decide whether to keep their relative on life support despite massive bodily injuries and little chance of survival.
Dr. J. Randall Curtis , a physician at the Harborview Intensive Care Unit, is trying to ease the burden on those families. Curtis, a UW associate professor of medicine in the Division of Pulmomary and Critical Care, has advocated for compassionate critical care, especially comfort for dying patients.
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| Harborview’s Dr. Randall Curtis (right) was honored nationally for compassionate care for Intensive Care Unit patients. |
Curtis was awarded the 2004 Grenvik Family Award for Ethics from the Society of Critical Care Medicine for promoting humane delivery of critical care. His efforts go beyond helping patients, however.
"Traditional critical care has focused on the patient," he said. "But there's growing recognition that high-quality critical care includes caring for the patient's family as well."
More physicians are trying to make communications with family members of a dying patient as positive an experience as possible, Curtis said. That can be difficult when family members are torn between wanting their relative around and believing their relative would not want to remain on life support.
Instead of asking family members to make that decision, for example, the health- care team can ask them what they think the patient would have wanted in a particular situation.
"It may help family members if they realize the decision isn't necessarily up to them, but that they're helping us determine what the patient would have wanted. Then we can make the difficult decisions," Curtis said.
Having Curtis explain that to her made all the difference for a woman whose elderly husband was on a ventilator and had multiple organ failure.
"I saw her face just light up when she realized that she didn't have to be the one to make a difficult decision that she knew he would want her to make," Curtis said.
In addition to working with patients and their families, Curtis also studies, teaches, and writes about compassionate care. He directs Harborview's End-of-Life Care Research Program, and co-edited the book Managing Death in the Intensive Care Unit: The Transition from Care to Comfort, published by Oxford University Press.