Withdrawal of life support: How the family feels, and why

The objectives of this study were to develop an instrument to assess the sa tisfaction of family members with withdrawal of life support (WLS), and to determine which factors are associated with greater levels of satisfaction. To do this, we developed a self-administered questionnaire that was sent t o the next-of-kin of intensive care unit (ICU) patients dying following WLS . Over a six-month period, 69 patients died following WLS in the ICU. Three letters were returned "address unknown", 33 did not respond, and 33 respon ded, of whom 29 agreed to participate (29/66 = 44% of those contacted). Of these, 24 (83%) strongly agreed with the patient's death being compassionat e and dignified, one moderately agreed, one mildly agreed, one was neutral and two strongly disagreed. Items associated with greater satisfaction incl uded: the process of WLS being well explained, WLS proceeding as expected, patient appearing comfortable, family/friends prepared for the decision, ap propriate person initiating discussion, adequate privacy during WLS, chance to voice concerns. The study suggests factors that are important to consid er in ensuring family comfort with the process of withdrawing life support.