
Contents
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Patients Patients
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Friends, Family, and Significant Others Friends, Family, and Significant Others
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Decision Makers Decision Makers
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Construing Their Role Construing Their Role
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Health Care Professionals Health Care Professionals
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Conclusion Conclusion
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Cite
Abstract
This chapter introduces health care providers in the ICU, patients, and especially their significant others. It depicts the misfortunes that brought patients to the ICU, their impact on patients’ decision-making capacity, and how capacity determinations are made. The chapter traces the worlds from which patients traveled and their very diverse backgrounds (age, race/ethnicity, marital status, religion, health insurance, affluence of residence). It shows the arrangements patients made in advance to plan for medical decision making on their behalf—including preparation of advance directives—and what happens when, as is usually the case, they made no preparations. The chapter introduces the friends and family who visit, interact with health care providers, and maintain the occasional vigil at the bedside. It describes their characteristics, the complex tangled family trees from which some travel, family dynamics, and the sometimes challenging or contentious struggles to determine who gets to speak on behalf of the patient. The chapter examines the relationship of surrogate decision makers to the patient and how the former come to understand their role and responsibilities. Finally, ICU health care professionals’ characteristics and bedside manner are described.
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