Seven Harms from Over-treatment in the ICU

There are at least seven discrete harms from over-treatment in the ICU:

1. Patient - The patient's autonomy is violated, because she is not getting treatment consistent with her preferences and values.


2. Patient - The patient will likely physically suffer from this over-treatment. 


3. Nurses - The nursing staff will likely experience moral distress.


4. Other Patients - The anxiety of the nursing staff can adversely impact their care of other patients.


5. Other Patients - Over-treating patients in the ICU means that other patients in need of that level of treatment will be boarded in the ED or elsewhere, increasing their risks.


6. Other Patients - over-treating can 'incubate' multi-drug resistant infections.


7. Society - Much over-treatment is billed to public payers like Medicare that we pay for but really cannot afford.