Critical care clinics
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A review of two decades of euthanasia advocacy reveals that the arguments in favor of euthanasia are not consistent. Although the Dutch debate on euthanasia started as a protest against contemporary medicine's power over death and dying, the general acceptance of euthanasia and recent litigation may have increased medical power by shifting the balance further in the direction of physicians. This article argues that the anxieties of some of the opponents of a euthanasia bill were justified.
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Critical care clinics · Jan 1996
ReviewEthically based medical decision making in the intensive care unit: residency teaching strategies.
It is important that educators in the intensive care unit (ICU) provide physicians in training with the guidance and experience requisite in developing foundational skills in value-based medical practice. This article discusses the underlying philosophy of ethically based medical decision making and describes the components of an educational program in medical humanities for the ICU. In particular, the authors focus on the central role of a relationship between the patient and the caregiver.
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Critical care clinics · Jan 1996
ReviewCritical care computing: outcomes, confidentiality, and appropriate use.
This article reviews the current limitations of computerized outcome predictor models and severity scoring systems. A logical extension of predictor models, a "computational futility metric," is proposed with a discussion of potential uses and abuses. These types of electronic surveillance will not solve the problem of society's denial of death or resolve the allocation of medical resources. Issues related to the protection of patients and physicians under electronic epidemiologic surveillance are discussed.
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Critical care clinics · Jan 1996
ReviewEthical issues in organ procurement: a review for intensivists.
The current state of organ procurement and the ethical issues raised by the procurement process are reviewed in this article. After an examination of the legislative framework governing organ procurement, the intensivist's role in donation is discussed, including (1) donor identification, (2) asking the family to donate, and (3) obtaining consent. Recent proposals for changing the organ procurement system are analyzed, including increasing family donation or increasing the donor pool.
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This article comprehensively addresses the composition, role, and functions of a hospital ethics committee (HEC). HECs are of particular interest to critical care specialists because they often participate in or lead such committees, extending their commitment to communication and caring beyond the borders of the intensive care unit (ICU). This article also demonstrates that a well-run ICU in a hospital with a strong HEC automatically will include many of the services that the HEC normally would provide, without the need for HEC assistance.