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. Author manuscript; available in PMC: 2014 Oct 1.
Published in final edited form as: J Crit Care. 2013 Jun 13;28(5):862–869. doi: 10.1016/j.jcrc.2013.04.015

Table 4.

Advantages and disadvantages of treatment trials presented by physicians in ICU family conferences

Time-Limited Trial
Advantages Example

Patient may recover But we want to give him a chance to recover from these few things that are happening right now.

In accordance with patient’s wishes And we want to respect his life and his wishes and not do things that would be beyond what he would want, you know.

Provide benefit to family I mean this period is to make sure that all friends… who might wish to see her … and if there are other relatives … have the opportunity, you know, I think for them to travel here, there’s still time…
… and then wait over the weekend, you have some time to get some sleep.

Disadvantages Example

Patient may not recover We feel that, in the next two days, if there’s not a real significant improvement, she’s not gonna make it.

Uncomfortable We don’t want to cause undue suffering.

Symptom-Limited Trial
Advantages Example

Patient may live longer I think that once we remove the breathing tube, he could continue to breathe fine, on his own, which would be what we would hope.

In accordance with patient’s wishes And what some families do decide is that they’re willing to take that risk, because their mother or wife wouldn’t want to have a hole in her trachea and have this prolonged course.

Non-invasive or more comfortable. So at that point, we wouldn’t need to be monitoring him.
So, if anything were to happen, he would just go and go comfortably.

Provide benefit to family But our goal would be to give him the medication, hopefully get him off of the ventilator pretty soon, even later today, so he could wake up and you guys could spend some time with him.

Disadvantages Example

Patient may not recover If you want, we can take it out [the breathing tube], but I’m just stating, it’s more of a risk.
We know that by doing that [removing the breathing tube], we run the risk that she may aspirate again. She may develop an aspiration and possibly a pneumonia with that.