On February 4th was held in Catalonia the XI Expert Conference of the Catalan Society of Intensive Care Medicine (SOCMIC) on the topic of End of Life Care (EOLC).

Several reflections for the audience:

1. There is an increased interest to improve care, attitudes and skills by professionals caring for patients in these situations (Dr. Francisco Fernández put us in background): Let´s take advantage of it!.

Dr. Marius Morlans also reminded us responsibility organizations have in good care at the end of life: Let´s engage it!.

 2. There is a legal and clear and defined regulatory framework that regulates ‘the right thing’ at the end of life (
Dr. Itziar de Lecuona made a magnificent exhibition waking us): Let´s know it!.

3. We have understood the necessity of integrating palliative care in our ICU thanks to Dr. Francisco Baigorri. Are you implementing it? If the answer is no, ask you why don´t you put in practice yet: Let´s put an expert in palliative care in the ICU!.

4. We have understood that multidisciplinary team focused on the person and the family, and by involving nursing (excellent talk on emotional support by Mrs Montse Busquets); primary care and other specialists… is the future: Let´s work as a team!.

5. EOLC is as important other processes, and we would like to create the “End of Life Care Code”, in which time is relief, and where EOLC experts detect and manage not only patients and families, also support professionals and focus on comfort care and improvement of the quality of life. To adapt the treatment and change the target to avoid lengthening the agony and suffering is also our professional duty (as Dr. Josep Teres reminded us): Let´s do it!.

6. We have learned that the new paradigm is not paternalism, nor the self-determination… But shared taking of decisions, where professional COMMUNICATES information honest, truthful, sensitive and properly (which is not the same, remembered us Dra. Assumpta Ricart). We should facilitate participatory decision making of the patient and families taking into account their values, their circumstances, their opinion: Let´s communicate in the best way, listen and respect!.

Much to learn, a lot by reflection, much for caring, as showed Dr. Lluis Cabré and Dr. Salvador Armengol and the public  in the discussion of clinical cases. IT IS POSSIBLE!.

A small improvement is the first step. Remember that “we are only a drop in the ocean, but the ocean would be less without this drop”. Everybody is important to do something to improve our end of life care.

Dr. Olga Rubio
Intensive Care PhysicianFundació Althaia Hospital Sant Joan de Déu