The National Hospice and Palliative Care Organization has issued a position statement calling for increased access to palliative care for patients in critical care settings.

More than one out of five deaths in the United States occur during or following admission to an Intensive Care Unit. At this critical time, palliative care providers can complement the knowledge and skills of critical care professionals in the areas of symptom management, assistance with decision making, and end-of-life care.

There are times when a given technology is not achieving the hoped-for benefit or is too difficult for the patient to continue. Additionally, patients overwhelmed with symptoms such as pain, difficulty breathing, or confusion, and families of patients in the ICU must oftentimes address difficult medical decisions. These individuals would all benefit from the availability of palliative care.

The focus of critical care is primarily to saves lives, commented J. Donald Schumacher, NHPCO president and CEO. This is not always possible “ not because of any lack of excellence on the part of critical care physicians, nurses, and others, but because some patients™ diseases are too advanced or their injuries are too severe. There are times when patients need additional care and support. They need palliative care.

NHPCO determined that there was sufficient concern related to the provision of palliative services in critical care settings to warrant the statement and call to action which was created by NHPCO™s Ethics Committee.

Strengthening access to palliative care in all critical care settings and promoting collaboration among all who are involved in this effort are the goals of NHPCO™s call to action.


Call to Action:

1. All eligible patients should have access to palliative care services.
2. Every critical care health care provider should review the National Consensus Project/National Quality Forum (NCP/NQF) guidelines for palliative care and hospice.
3. Every health care system should adopt the preferred practices as they apply in the critical care setting.
4. Every critical care health care provider should be educated in the principles of palliative care.
5. Current evidence-based practices related to palliative care should be used in the treatment of patients.
6. Palliative care services within critical care must be evaluated using an accepted continuous quality improvement methodology.

As the statement was developed, the document was shared with colleagues working with the Center to Advance Palliative Care, the Hospice and Palliative Nurses Association, and the Society of Critical Care Medicine.

Hospice and palliative providers are encouraged to utilize the document as they partner with critical care providers.

The position statement is available at

National Hospice and Palliative Care Organization (NHPCO)
Jon Radulovic
VP of Communications