“Ethics committee in ICU: Extubation, breathing tube removal, and family decisions explained!”

My name is Patrik Hutzel from intensivecarehotline.com, where we instantly improve the lives for families of critically ill patients in intensive care, so that you can make informed decisions, have peace of mind, control, power, and influence, even if you’re not a doctor or a nurse in intensive care, making sure your loved one always gets best care and treatment.

So, today I have a question from Rob, who’s one of our clients as his mother in ICU and he says:

“Hi Patrik,

I spoke to the ICU doctors, and they said they’re willing to have a decision made on my mom about extubation to remove the breathing tube. The people are called ethics committee people. Any thoughts on this?

From, Rob.”

Well, thank you, Rob, for your question, and it’s a question that we get all the time here at intensivecarehotline.com.

Now, from my experience, having worked in critical care nursing for over 25 years in three different countries, when an ethics committee gets involved in ICU discussions, especially around extubation or removal of the breathing tube, it’s often a sign that there’s a disagreement or uncertainty between the medical team and the families about the next steps.

Let me explain what this actually means and what you can do next.

The ethics committee in an ICU setting is typically made up of hospital staff such as doctors, nurses, social workers, and sometimes, clergy. Their job is to review ethical concerns like whether to continue life sustaining treatment, perform a tracheostomy, or move towards end-of-life care decisions.

However, families must understand the elephant in the room, and they must understand that ethics committees often act in the hospital’s best interest, not necessarily in your loved one’s best interest. They often focus on resource management, bed availability, and what they consider “futility of care,” and I can say, it’s mainly perceived futility of care. Please keep in mind that 70 to 90% of ICU patients survive, so why would your loved one not survive? So, the odds are actually in your mom’s favor.

Now also, I can give you an example from my own practice in ICU. I remember many years ago now, where I looked after a patient in ICU, a young patient, where the ICU team issued a DNR (Do Not Resuscitate) without patient or family’s consent, and that’s illegal. I called out the ICU doctors on that. I said, “You can’t just issue a DNR without patient or family consent. You need to revoke that and revoked; it got! Because I know about patients’ rights and I know about family’s rights.

One of the doctors was challenging me basically saying, “Well, I’m on the ethics committee and I’ve done a masters in ethics.” And I said, “Well, that’s fine, but you’re not acting very ethically.” And that was part of the ethics committee. So, it’s all about the hospital’s interests. I’ve got enough real-world experience either in ICU or now with consulting and advocacy. You got to read between the lines, and you got to call out the nonsense there is.

Coming back to your question, Rob, if your mom is not ready to be extubated but could potentially improve with more time, or if a tracheostomy is a better option, then you should not agree to an extubation that could lead to her death. The tracheostomy can provide more comfort, allow more time for recovery, and even open the door for a discharge home with Intensive Care at Home, and you can get more information at intensivecareathome.com, where your mom can receive 24/7 ICU nursing outside of the ICU in the comfort of your own home.

So, before making any decisions with the ethics committee, make sure you agree to an ethics committee meeting. If you don’t agree to that, just ask them, you don’t want it. Ask for the hospital policy about ethics committees. The hospital policy about ethics committee might say that you need to agree and approve that an ethics committee meeting will be held. Make sure you cover yourself.

Ask for full medical updates, get access to all medical records, including ventilator settings, blood gases, and sedation status, but make sure you have access to all medical records in real time. Request a family meeting with all key members of the medical team and your family present. Ask for more time. You don’t have to make any rushed decisions.

Get expert help from us at intensivecarehotline.com, where we guide you step by step through this process, including how to handle ethics committees, tracheostomy discussions, and discharge options like Intensive Care at Home. So, go to intensivecarehotline.com now and call us on one of the numbers on the top of our website or send us an email to [email protected] so that we can help you fast track the right decisions for your mom and making sure your mom gets best care and treatment always.

Because we’ve helped hundreds if not thousands of families in intensive care in exactly your situation to avoid premature, unnecessary extubations, get tracheostomies when appropriate, and bring your loved one’s home with Intensive Care at Home.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

The biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on the show. You will get notification for the YouTube live if you are a subscriber to my YouTube channel or my intensivecarehotline.com email newsletter at intensivecarehotline.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

Related Articles:

Quick Tip for Families in Intensive Care: My Husband’s Hemoglobin Has Dropped to Below 7 & He’s Scheduled for a Tracheostomy, Is It Dangerous? Quick Tip for Families in Intensive Care: My Mother in ICU Passed Away After I Signed a DNR (Do Not Resuscitate) in Good Faith! I Think it was a Mistake! Next Testimonial from a Happy INTENSIVE CARE HOTLINE Client, Thank You for Saving My Brother’s Life! My Ventilated Husband in ICU Has a Bleed, Encephalitis, and No Nutrition for 11 Days & Now They Want a DNR! Quick Tip for Families in ICU! Quick Tip for Families in ICU: How Long Can a Critically Ill Patient Be on a Ventilator in ICU Before Brain Damage Occurs?