Withdrawal of intensive care treatment at home--'a good death'.

A patient with end-stage congestive cardiac failure and acute renal failure was admitted to the intensive care unit for inotropic support. Following no improvement with treatment, the focus of care shifted to the patient's comfort, palliative care and family support. She wished to die at home and therefore all efforts were made to fulfil her desire. This was achieved and she was discharged from the intensive care unit on inotropes and allowed to die in the comfort of her own home, with the withdrawal of treatment occurring only when the patient was ready.