Critical care clinics
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This article provides a brief review of the history of euthanasia. The problems involved in withholding or withdrawing treatment, physician-assisted suicide, and arguments for or against euthanasia are discussed. Changes in both societal and physician attitudes and practices are presented.
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Critical care clinics · Jan 1996
ReviewNeonatal and pediatric critical care: ethical decision making.
The current standards for surrogate decision making for children are analyzed in this article. A number of potential pitfalls are involved with this issue, including questions about the child's maturity and competence. The present approach for medical decision making for noncompetent children is the "best interest" standard. In many medical decisions, the "best interest" standard is not applicable and a "rational parent" standard is presented.
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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.