July

Thank you for your interest in our article. As you point out, the skillful diagnosis, prevention, and management of delirium is critical to promote the best outcomes for patients at any age, and in all areas of the hospital, including the ICU.

Despite high-yield research and scholarship regarding delirium, it continues to be a major complication associated with an intensive care unit (ICU) experience. Referenced work in this manuscript [BCMJ 2017;59:165-170] conducted by Inouye was expansive and helpful; however, foundational work conducted by Dr Ely’s research group was missing.

Hardly a day goes by without a letter/blog/essay/opinion piece about assisted suicide or MAID. To me, it is clear that no person is under a legal duty—contractual, statutory, or otherwise—to participate in any treatment to which he or she has a conscientious objection. Undoubtedly the words participate and any treatment are spring loaded and bound to elicit strong emotions and disagreement among readers. For me personally, helping a terminally ill patient into the afterlife with terminal sedation is one thing.

It may be the current bizarre state of the world, or just that I’m getting older, but I’m growing concerned about our ability to communicate with each other. Political partisanship, to begin with, and regional and other factors make us unwilling or unable to share perspectives. But my concern is more personal than that. I think we are just forgetting how to talk to each other. A ride on public transport will confirm this: count the number of people talking to each other compared to those fixated on a smart phone or laptop. It’s unsettling.

“This hundred-year-old female was admitted feeling poorly. We didn’t do much, but she felt a bit better after a few days and went home.”