Medical Decision Making in Critical Care The Patient as a Person
Physicians are professionals, and the highest professional ethical standard places the welfare of the professional’s patients first and foremost. Problems involved with intensive care and organ failure exemplify both the high cost of health care and poor or limited prognosis of terribly sick patients in combination with concerns about privacy, dignity, the primacy of the individual, and the right to die peacefully with one’s loved ones close at hand. No respectable physician prolongs life by mechanical or artificial means when it is unnecessary, unqualitative, or futile. But how does one determine necessity or quality or futility? Ethical discussions abound; living wills attempt to control one’s fate, and legal battles continue.
KeywordsIntensive Care Unit Multiple Organ Failure Medical Decision Advanced Directive Hippocratic Oath
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- 1.Baue AE (1990) The sociology of multiple organ failure. In: Baue AE, Multiple organ failure: Patient care and prevention. Mosby Year Book, St. Louis, pp 515–518Google Scholar
- 2.Baue AE (1990) The patient as a person: Ethical considerations of patients with multiple organ failure. In: Baue AE, Multiple organ failure: Patient care and prevention. Mosby Year Book, St. Louis, pp 512–514Google Scholar
- 4.Vaus K (1974) Biomedical ethics: Morality for the new medicine. Harper & Row, New YorkGoogle Scholar
- 5.Harron F, Burnside J, Beauchamp T (1983) Health and human values: A guide to making your own decisions. Yale University Press, New HavenGoogle Scholar
- 6.Levine H (1986) Life choices: Confronting the life and death decisions created by modern medicine. Simon & Schuster, New YorkGoogle Scholar
- 7.Bulger RJ (1987) On the drinking of hemlock: Socrates, Semmelweis, and Barbara McClintock; Erikson EH: The Golden Rule and the cycle of life; Pellegrino ED: Toward an expanded medical ethics: the Hippocratic ethic revisted. In: Bulger RJ (ed) In search of the modern Hippocrates. University of Iowa Press, Iowa CityGoogle Scholar
- 8.Behringer E, Steinberger HA, Price J et al (1996) Correlations between do not resuscitate (DNR) orders and advanced directives in SICU patients who expire. Crit Care Med 24:A2Google Scholar
- 9.Fakhry SM, Gaafar BS, Welna SM et al (1996) “Do-not-resuscitate” orders in critical care: An immediate prelude to withdrawal of support. Crit Care Med 24:A2Google Scholar
- 12.Compiled from News Services (1995) Patients’ care seldom matches their wishes: Efforts to prolong life cause suffering for dying, study finds, St. Louis Post-Dispatch, Wednesday, November 22Google Scholar
- 17.Eiseman B (1995) Independence, pain relief rated top therapeutic goals: Elderly emphasize quality of life over duration. General Surgery & Laparoscopy News, pp 1–3Google Scholar
- 18.Testa MA, Simonson DC (1996) Assessment of quality-of-life outcomes. Current Concepts 334(13):835–840Google Scholar