The clinical accuracy of peer-reviewed medical literature is evolving rapidly and with it the potential to learn a great deal about achieving benefit in critical care.1 The advent of the Internet and electronic bulletin boards led to real-time contact with a multinational pool of working physicians, as well as up-to-the-minute data regarding patient care on a multinational platform.2 This has created a new global medical village, in which the furthest citizens reside just around the corner. In 1994, CCM-L (http://ccm-l.med.edu), the first medical bulletin board dedicated to the specialty of critical care medicine, was founded. At the time of this writing, a multinational contingent of about 1000 CCM-L subscribers, including physicians, pharmacists, nurses, other interested providers, medical ethicists, and researchers, access a sophisticated mail server located at the University of Pittsburgh in Pennsylvania. About half live and work outside the United States. The purpose of CCM-L is to provide a forum to discuss, and to maintain a data bank for, the holistic daily care of the patient as it pertains to the intensive care setting. Included in the discussion are problems associated with limitation, withholding, and withdrawal of life support. CCM-L provided the platform from which the opinions that form this work were drawn.
Critical Care Critical Care Physician Brain Failure Health Care Consumer Fair Game
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