Abstract
Critical care physicians, particularly neurointensivists, are faced with daily complex bioethical issues that often times are very difficult to solve. Despite the amount of time spent dealing with these problems, there is little training in this area in both graduate and postgraduate medical training programs. Therefore, most of what is learned comes from observing senior clinical faculty, making adequate training variable and difficult to assess.
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References
Gert B, Culver CM, Clouser KD, eds. Bioethics. A Return to Fundamentals. New York: Oxford University Press, 1997.
Bernat JL, ed. Ethical Issues in Neurology. Boston: Butterworth-Heineman, 2002.
Jonsen AR, Siegler M, Winslade WJ, eds. Clinical Ethics, 4th ed. New York: McGraw Hill, 1998.
Beauchamp TL, Childress JF, eds. Principles of Biomedical Ethics, 5th ed. New York: Oxford University Press, 2001.
Caplan AL, Coehlo DH, eds. The Ethics of Organ Transplants: The Current Debate. Amherst, NY: Prometheus Books, 1998.
Youngner SJ, Fox RC, O’Connell LJ. Organ Transplantation: Meanings and Realities. Madison, WI: The University of Wisconsin Press, 1996.
Youngner SJ, Arnold RM, Schapiro R, eds. The Definition of Death: Contemporary Controversies. Baltimore: The Johns Hopkins University Press, 1999.
Hanks P, ed. Collins Dictionary of the English Language, 2nd ed. London and Glasgow: Collins, 1986: 1000.
Hanks P, ed. Collins Dictionary of the English Language, 2nd ed. London and Glasgow: Collins, 1986: 101
Hanks P, ed. Collins Dictionary of the English Language, 2nd ed. London and Glasgow: Collins, 1986: 829.
Marshall MF, Schwenzer KJ, Orsina M, Fletcher JC, Durbin CG Jr. Influence of political power, medical provincialism, and economic incentives on the rationing of surgical intensive care unit beds. Crit. Care Med. 1992; 20: 387–394.
Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. JAMA 1992; 267: 2221–2226.
Cook D. Patient autonomy versus parentalism. Crit. Care Med. 2001; 29: N24–N25.
Meier DE, Morrison RS. Autonomy reconsidered. N. Engl. J. Med. 2002; 346: 1087–1089.
Prendergast TJ. Advance care planning: pitfalls, progress, promise. Crit. Care Med. 2001; 29: N34–N39.
Annas GJ. Nancy Cruzan and the right to die. N. Engl. J. Med. 1990; 323: 670–673.
Annas GJ, Arnold B, Aroskar M, et al. Bioethicists’ statement on the US Supreme Court’s Cruzan decision. N. Engl. J. Med. 1990; 323: 686.
Fins JJ, Solomon MZ. Communication in intensive care settings: The challenge of futility disputes. Crit. Care Med. 2001; 29: N10–N15.
Curtis JR, Patrick DL, Shannon SE, Treece PD, Engelberg RA, Rubenfeld GD. The family conference as a focus to improve communication about end-of-life care in the intensive care unit: ooportunities for improvement. Crit. Care Med. 2001; 29: N26–N33.
Vincent JL. Cultural differences in end-of-life care. Crit. Care Med. 2001; 29: N52–N55.
Fried TR, Bradley EH, Towle VR, Allore H. Understanding the treatment preferences of seriously ill patients. N. Engl. J. Med. 2002; 346: 1061–1066.
Pendergast TJ, Luce JM. Increasing incidence of withholding and withdrawal of life support from the critically ill. Am. J. Respir. Crit. Care Med. 1997; 155: 15–20.
Prendergast TJ, Claessens MT, Luce JM. A national survey of end-of-life care of critically-ill patients. Am. J. Respir. Crit. Care Med. 1998;158:11,163–11,167
Faber-Langendoen K. A multi-institutional study of care given to patients dying in hospitals. Ethical and practice implications. Arch. Intern. Med. 1996; 156: 2130–2136.
Mayer SA, Kossoff SB. Withdrawal of life support in the neurological intensive care unit. Neurology 1999; 12: 1602–1609.
Support Principal Investigators: a controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators. JAMA 1995;274:1591–1598.
Weir RF, Gotlin L. Decisions to abate life-sustaining treatment for nonautonomous patients. Ethical standards and legal liability after Cruzan. JAMA 1990; 264: 1846–1853.
Luce JM. Ethical principles in critical care. JAMA 1990; 263: 696–700.
American Thoracic Society. Withholding and withdrawing life-sustaining therapy. Am. Rev. Respir. Dis. 1991; 144: 726–731.
Faber-Langendoen K, Lanken PN, for the ACP-ASIM End-of-Life Care Consensus Panel. Dying patients in the intensive care unit: forgoing treatment, maintaining care. Ann. Intern. Med. 2000; 133: 886–893.
Nyman DJ, Sprung CL. End-of-life decision making in the intensive care unit. Intensive Care Med. 2000; 26: 1414–1420.
Truong RD, Cist AF, Brackett SE, et al. Recommendations for end-of-life care in the intensive care unit: The Ethics Committee of the Society of Critical Care Medicine. Crit. Care Med. 2001; 29: 2332–2348.
Singer PA, Martin DK, Kelner M. Quality end-of-life care: Patients’ perspectives. JAMA 1999; 281: 163–168.
Danis M, Federman D, Fins JJ, et al. Incorporating palliative care into critical care education: Principles, challenges, and opportunities. Crit. Care Med. 1999; 27: 2005–2013.
Council on Scientific Affairs American Medical Association. Good care of the dying patient. JAMA 1996; 275: 474–478.
Hampe SO. Needs of the grieving spouse in a hospital setting. Nurs. Res. 1975; 24: 113–120.
Furukawa MM. Meetings the needs of the dying patient’s family. Crit. Care Nurse 1996; 16: 51–57.
Asch DA. The role of critical care nurses in euthanasia and assisted suicide. N. Engl. J. Med. 1996; 334: 1374–1379.
Brody H, Campbell ML, Faber-Langendoen K, et al. Withdrawing intensive life-sustaining treatment—Recommendations for compassionate clinical management. N. Engl. J. Med. 1997; 336: 652–657.
McCann RM, Hall WJ, Groth-Juncker A. Comfort care for terminally ill patients: The appropriate use of nutrition and hydration. JAMA 1994; 272: 1263–1266.
Printz LA. Terminal dehydration, a compasionate treatment. Arch. Intern. Med. 1992; 152: 697–700.
Gillick MR. Rethinking the role of tube feeding in patients with advanced dementia. N. Engl. J. Med. 2000; 342: 206–210.
Gilligan T, Raffin TA. Withdrawing life support: Extubation and prolonged terminal weans are inappropriate. Crit. Care Med. 1996; 24: 352–353.
Gilligan T, Raffin TA. Rapid withdrawal of support. Chest 1995; 108: 1407–1408.
Krishna G, Raffin TA. Terminal weaning from mechanical ventilation. Crit. Care Med. 1999; 27: 9–10.
Gianakos D. Terminal weaning. Chest 1995; 108: 1405–1406.
Campbell ML, Frank RR. Experience with an end-of-life practice at a university hospital. Crit. Care Med. 1997; 25: 197–202.
Campbell ML. Breaking bad news to patients. JAMA 1994; 271: 1052.
Krahn GL, Hallum A, Kime C. Are there good ways to give “bad news”? Pediatrics 1993; 91: 578–582.
Ptaceck JT, Eberhardt TL. Breaking bad news. JAMA 1996; 276: 496–502.
Quill TE, Townsend P. Bad news: delivery, dialogue, and dilemmas. Arch. Intern. Med. 1991; 151: 463–468.
Williams MA, Suarez JI. Brain death determination in adults: more than meets the eye. Crit. Care Med. 1997; 25: 1787–1788.
Plum F. Clinical standards and technological confirmatory tests in diagnosing brain death. In Youngner SJ, Arnold RM, Schapiro R, eds. The Definition of Death. Contemporary Controversies. Baltimore: The Johns Hopkins University Press, 1999: 34–65.
Brody BA. How much of the brain must be dead? In Youngner SJ, Arnold RM, Schapiro R, eds. The Definition of Death. Contemporary Controversies. Baltimore: The Johns Hopkins University Press, 1999: 72–82.
Halevy A, Brody B. Brain death: Reconciling definitions, criteria, and tests. Ann. Intern. Med. 1993; 119: 519–525.
Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. A definition of irreversible coma. JAMA 1968; 205: 337–340.
Youngner SJ. Brain death: A superficial and fragile consensus. Arch. Neurol. 1992; 49: 570–572.
O’Connell LJ. The realities of organ transplantation. In Youngner SJ, Fox RC, O’Connell LJ, eds. Organ Transplantation. Meanings and Realities. Madison, WI: The University of Wisconsin University Press, 1996: 19–31.
Caplan AL. Ethical and policy issues in the procurement of cadaver organs for transplantation. In Caplan AL, Coehlo DH, eds. The Ethics of Organ Transplants. The Current Debate. Amherst: Prometheus Books, 1998: 142–146.
Federal Register Final Rule: Hospital Conditions for Participation for Organ Donation (42 CFR Part 482), 2000.
Centers for Medicare and Medicaid Services (CMS), HHS. Medicare and Medicaid programs; emergency recertification for coverage for organ procurement organizations (OPOs). Interim final rule with comment period. Fed. Regist. 2001;66:67,109–67,111.
Gortmaker SL, Beasley CL, Sheehy E, et al. Improving the request process to increase family consent for organ donation. J. Transpl. Coord. 1998; 8: 210–217.
Kerridge IH, Saul P, Lowe M, McPhee J, Williams D. Death, dying and donation: organ transplantation and the diagnosis of death. J. Med. Ethics 2002; 28: 89–94.
Merle JC. A Kantian argument for a duty to donate one’s own organs. A reply to Nicole Gerrand. J. Appl. Philos. 2000; 17: 93–101.
Murray TH. Are we morally obligated to make gifts of our bodies? Health Matrix J. Law Med. 1991; 1: 19–29.
Pugliese MR, Degli Esposito D, Venturoli N, et al. Hospital attitude survey on organ donation in the Emilia-Romagna region, Italy. Transpl. Int. 2001; 14: 411–419.
Spital A. Mandated choice for organ donation: time to give it a try. Ann. Intern. Med. 1996; 125: 66–69.
Klassen AC, Klassen DK. Who are the donors in organ donation? The family’s perspective in mandated choice. Ann. Intern. Med. 1996; 125: 70–73.
Youngner SJ. Some must die. In Youngner SJ, Fox RC, O’Connell LJ, eds. Organ Transplantation. Meanings and Realities. Madison, WI: The University of Wisconsin University Press, 1996: 32–55.
Fiedler LA. Why organ transplant programs do not succeed. In Youngner SJ, Fox RC, O’Connell LJ, eds. Organ Transplantation. Meanings and Realities. Madison, WI: The University of Wisconsin University Press, 1996: 56–65.
Ott BB. Defining and redefining death. In Caplan AL, Coehlo DH, eds. The Ethics of Organ Transplants. The Current Debate. Amherst: Prometheus Books, 1998: 16–23.
Murray TH. Organ vendors, families, and the gift of life. In Youngner SJ, Fox RC, O’Connell LJ, eds. Organ Transplantation. Meanings and Realities. Madison, WI: The University of Wisconsin University Press, 1996: 101–125.
Guy BS, Aldridge A. Marketing organ donation around the globe. Mark Health Serv. 2001; 21: 30–35.
Lovasik D. Brain death and organ donation. Crit. Care Nurs. Clin. North Am. 2000; 12: 531–538.
Bollinger RR, Heinrichs DR, Seem DL, et al. Organ procurement organization (OPO), best practices. Clin. Transplant 2001; 15 (suppl 6): 16–21.
Andresen J. Cultural competence and health care: Japanese, Korean, and Indian patients in the United States. J. Cult. Divers. 2001; 8: 109–121.
Samaritan Transplant Services, Phoenix, AZ. Development of a culturally sensitive, locality-based program to increase kidney donation. Adv. Ren. Replace. Ther. 2002; 9: 54–56.
Youngner SJ. Applying futility: Saying no is not enough. JAGS 1994; 42: 887–889.
Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: its meanings and implications. Ann. Intern. Med. 1990; 112: 949–954.
Jecker NS, Schneiderman LJ. Futility and rationing. Am. J. Med. 1992; 92: 189–196.
Brett AS, McCullough LB. When patients request specific interventions. N. Engl. J. Med. 1986; 15: 1347–1351.
McCrary SV, Swanson JW, Youngner SJ, Perkins JS, Winslade WI. Physicians’ quantitative assessments of medical futility. J. Clin. Ethics 1994; 5: 100–105.
Gilgun v. Massachusetts General Hospital. Mass. Sup. Ct., April 21, 1995. (No. 92–4820).
In re Helga Wanglie, Fourth Judicial District (Dist. Ct., Probate Ct. Div.) PX-91–283. Minnesota, Hennepin County.
Angel M. The case of Helga Wanglie: A new kind of “right to die” case. N. Engl. J. Med. 1991; 325: 511–512.
Capron AM. Medical futility: Strike two. Hastings Ctr. Rep. 1994;September-October:42–43.
Helft PR, Siegler M, Lantos J. The rise and fall of the futility movement. N. Engl. J. Med. 2000; 343: 293–296.
Halevy A, Brody BA. A multi-institutional collaborative policy on medical futility. JAMA 1996; 276: 571–574.
Tsai E. Should family members be present during cardiopulmonary resuscitation? N. Engl. J. Med. 2002; 346: 1019–1021.
Doyle CJ, Post H, Burney RE. Family participation during resuscitation: an option. Ann. Emerg. Med. 1987; 16: 673–675.
Dubin WR, Sarnoff JR. Sudden unexpected death: intervention with the survivors. Ann. Emerg. Med. 1986; 15: 54–57.
Anderson AH, Bateman LH, Ingallinera KL, et al. Our caring continues: A bereavement follow-up program. Focus Crit. Care 1991; 18: 523–526.
McClelland ML. Our unit has a bereavement program. Am. J. Nurs. 1993; 93: 62–68.
DeCastro LD. Exploitation in the use of subjects for medical experimentation: A re-examination of basic issues. Bioethics 1995; 9: 259–268.
Emanuel EJ, Wendler D, Grady C. What makes clinical research ethical? JAMA 2000; 283: 2701–2711.
US Food and Drug Administration. Protection of human subjects: informed consent and waiver of informed consent requirements in certain emergency research; final rules. Fed. Regist. 1996;61:51,497–51,531
Moreno J, Caplan AL, Wolpe PR, and the Members of the Project on Informed Consent, Human Research Ethics Group. Updating protections for human subjects involved in research. JAMA 1998; 280: 1951–1958.
Dresser R. Mentally disabled research subjects: The enduring policy issues. JAMA 1996; 276: 67–72.
Capron AM. Ethical and human-rights issues in research on mental disorders that may affect decision-making capacity. N. Engl. J. Med. 1999; 340: 1430–1434.
American College of Physicians. Cognitively impaired subjects. Ann. Intern. Med. 1989; 111: 843–848.
Biros MH, Lewis RJ, Olson CM, Runge JW, Cummins RO, Fost N. Informed consent in emergency research. Consensus statement from the coalition conference of acute resuscitation and critical care researchers. JAMA 1995; 273: 1283–1287.
Levine RJ. Research in emergency situations. The role of deferred consent. JAMA 1995; 273: 1300–1302.
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Suarez, J.I., Youngner, S. (2004). Bioethical Issues in the Neurosciences Critical Care Unit. In: Suarez, J.I. (eds) Critical Care Neurology and Neurosurgery. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-660-7_15
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DOI: https://doi.org/10.1007/978-1-59259-660-7_15
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