When recovery is not possible

Monitoring and treating patients with life-threatening conditions 

In some patients, despite receiving clinical care treatment, it becomes clear that there is no realistic hope of their recovery. In these circumstances, prolonging their life-supporting treatment has no benefit to the patient. It may also be distressing to both the patient and relatives.

Decisions

At this stage, care may move towards providing comfort and palliation (reducing distressing symptoms). Stopping existing treatments may also be considered.

Decisions such as these are only made when the whole clinical team is in agreement and after full and repeated discussions with the patient's relatives. It is important for relatives to be involved in any decisions made, however, the decision to stop treatments will rest mainly with the critical care consultant when the patient cannot make his/her own decision. 

When the decision has been made to stop life-supporting treatment we will continue to make sure the patient is as comfortable as possible and has a peaceful and dignified death.

We are here to support the patient's family and friends at this difficult time. Please speak to the doctors and nurses if you have any questions or concerns.

After a patient dies

Organ donation

Organ donation is only discussed once all appropriate options or treatments have been considered. There are very few restrictions to donation. Most people are eligible to donate.

Organ donation does not:

  • prevent families from visiting the patient in the chapel of rest after donation
  • delay or alter funeral arrangements
  • take away the pain of loss, but making the choice to save the lives of others can give meaning at the time of death and may provide comfort later.

Transplant coordinators (specialist nurses working in organ donation) can give advice and support to families. Critical care staff are not part of the transplant team, however they will continue to care for the patient and make sure that their dignity is respected at all times.

Referral to the coroner

In the United Kingdom, if a patient dies unexpectedly following an operation, or if the cause of death is unclear, we may need to report this death to the coroner.  The patient's doctor will inform the next of kin when this happens and answer any questions you might have. Please visit the Ministry of Justice website for more information.

Our bereavement service

The hospital bereavement service offers advice and support to relatives. They can tell you what you need to do after a loved one has died - from registering the death to how to arrange a burial or cremation. 

  • To make an appointment to see a bereavement officer please call 020 7188 3215 (Guy's) or 020 7188 3182 (St Thomas').

  • You may be too shocked to ask questions following the sudden or unexpected death of a loved one. To speak to the patient's critical care matron or doctor at a later date, please arrange an appointment via the critical care secretary on 020 7188 3044 or write to: Critical care secretary, 1st floor East Wing, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH