Critical and Intensive Care Ethics  

Oleh:

Levin, Phillip D. ; Sprung, Charles L.

Jenis: Article from Books - E-Book
Dalam koleksi: The Cambridge Textbook of Bioethics, page 462-468.
Topik: Critical; Intensive Care; Ethics; Triage; End of Life Care
Fulltext: Critical and Intensive Care Ethics.pdf (286.62KB)

Isi artikel

A 70-year-old male patient (Patient E) is admitted to the intensive care unit (ICU) following a road traf?c accident in which he suffered severe head and abdominal injuries. After four weeks in the ICU, the patient’s neurological condition has stabilized with minimal function (the patient does not communicate but withdraws all four limbs to painful stimuli). Following numerous bouts of sepsis, the patient is developing renal failure. He is anuric, hyperkalemic, and acidotic. He is also ventilator dependent and on high doses of inotropes. The patient’s family states that in their culture, life continues until the heart stops beating. The family (that includes a physician) requests that all resuscitative efforts be continued, including dialysis. In parallel, a second patient (Patient F) with similar injuries, but with metastatic prostate cancer, is admitted to the emergency room and requires an ICU bed. In addition to his traumatic injuries, however, he is wheel-chair bound as a result of dementia. No beds are currently available. According to the assessment of the ICU physician attending, the trauma patient described in case one has the least to bene?t from ICU therapy and should be assessed for with- drawal of ventilation, to which the family strenuously objects.

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