"No Escalation of Treatment" Designations: A Multi-institutional Exploratory Qualitative Study.

Background: No Escalation of Treatment (NoET) designations are used in ICUs internationally to limit treatment for critically ill patients. However, they are the subject of debate in the literature and have not been qualitatively studied.

Research Question: How do physicians understand and perceive NoET designations, especially regarding their usefulness and associated challenges? What mechanisms do hospitals provide to facilitate the use of NoET designations?

Study Design And Methods: Qualitative study at seven US hospitals, employing semistructured interviews with 30 physicians and review of relevant institutional records (eg, hospital policies, screenshots of ordering menus in the electronic health record).

What Does the Word "Treatable" Mean? Implications for Communication and Decision-Making in Critical Illness.

Objectives: To explore how nonphysicians and physicians interpret the word "treatable" in the context of critical illness.

Design: Qualitative study using in-depth interviews.

Setting: One academic medical center.

Challenges to code status discussions for pediatric patients.

Objectives: In the context of serious or life-limiting illness, pediatric patients and their families are faced with difficult decisions surrounding appropriate resuscitation efforts in the event of a cardiopulmonary arrest. Code status orders are one way to inform end-of-life medical decision making. The objectives of this study are to evaluate the extent to which pediatric providers have knowledge of code status options and explore the association of provider role with (1) knowledge of code status options, (2) perception of timing of code status discussions, (3) perception of family receptivity to code status discussions, and (4) comfort carrying out code status discussions.

Practical Implications of the Minimally Conscious State Diagnosis in Adults.

This article addresses questions surrounding the minimally conscious state (MCS) from the perspective of adult clinical ethics. It describes the background of the MCS diagnosis, analyzes phenomenological ambiguities inherent in the nature of MCS, and raises epistemological concerns surrounding its diagnosis. It argues that in many cases, the burdens of prolonging treatment for people who have sustained certain severe brain injuries (SBI) outweigh the benefits, even if they are in or have the prospect of entering into MCS.

Subglottic Stenosis Following Cardiac Surgery With Cardiopulmonary Bypass in Infants and Children.

Objectives: To determine the 1) incidence of subglottic stenosis in infants and children following cardiac surgery with cardiopulmonary bypass and 2) risk factors associated with its development.

Design: Retrospective cohort study.

Setting: Tertiary children's hospital in California.