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The poor quality of interpersonal communication is the main reason for the dissatisfaction intensive care patients and their family members often experience. Yet interpersonal communication is considered an important means of conveying information, providing psychological support, and preventing conflicts which can arise when communication is ineffective and information is misunderstood. Good communication is, therefore, an essential part of therapy. This study examines the factors that can hinder communication between clinicians, patients and their family members and the strategies needed to overcome the obstacles to good communication. The results of the study showed that training in the development of relational skills and communicative competence within the intensive care setting should be directed towards the promotion of decision-making processes shared among medical personnel, patients and their family members. In this way, conflict can be reduced and the quality of medical care improved.

The bioethical interpretation concerns both those receiving intensive care (IC) and the nature of the treatment itself. The principle of autonomy expressed in the doctor-patient relationship is achieved through the use of informed consent and may also be used in the unique context of patients in IC. Organ-function replacement treatment raises the ethical question of the definition and management of the limit to treatment. The appropriateness of IC can be defined by clinical and ethical criteria and aims to avoid inappropriately excessive treatment. In order to improve the decision-making process involving bioethical questions, the authors outline a number of working approaches: the use of informed consent even in IC, the possible role of Advanced Directives in IC, epidemiological studies, operator training.