Communication in intensive care settings: The challenge of futility disputes

In intensive care settings, suboptimal communication can erode family trust and fuel so-called "futility" disputes. Presenting a teaching case used by >225 hospitals participating in the Decisions Near the End-of-Life program , we identify critical communication challenges and opportunities. We empha size that good communication requires not only clear and sensitive language but also clinician self-awareness, psychological insight, and an instituti onal culture that promotes good communication with families. The article co ncludes with two examples of steps institutions can take to faster good com munication between families and healthcare professionals.