Humanizing the intensive care unit

In the midst of trying to correct organ failures, clinicians may neglect to carefully consider what the patient is experiencing: to be on the brink of death, be unable to speak, be stripped naked, have strangers enter the room and simultaneously do things to their bodies without explanation, have tubes inserted into multiple orifices, have their arms restrained, hear a cacophony of disorienting bedside alarms whose meaning lies beyond them, and to be poked, and prodded—all while family is torn away. Compounding these facts, patients often have no memory or understanding of how they ended up in this horrifying situation. Encephalopathy makes it difficult for patients to make sense of the myriad painful stimuli they encounter. Patients and families must surrender all control. In all of this perceived chaos, some patients who experience critical illness may experience a loss of their humanity in the process. This loss of humanity may come in many forms, including the loss of personal identity, control, respect, privacy, and support systems, and is referred to as dehumanization (Fig. 1). Dehumanization consists of treating someone as an “object” rather than a “person” and is often associated with failures to honor dignity