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An Ethical Assessment of Intensive Care

Published online by Cambridge University Press:  14 October 2009

Celine Marsden
Celine Marsden
Affiliation:
University of Southern California
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Abstract

Any evaluation of intensive care must include an ethical assessment of that technology. This allows us to consider the use of technologyin light of the ends that we desire. The most pressing ethical issues in intensive care are: forgoing life-sustaining treatment, dehumanization of patients and staff within the technological environment, and the allocation of the technology that is integral to intensive care.

Type
Special Section: Intensive Care: Where Are We?
Information
International Journal of Technology Assessment in Health Care , Volume 8 , Issue 3 , Summer 1992 , pp. 408 - 418
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

1.Allan, J. D., & Hall, B. A.Challenging the focus on technology: A critique of the medical model in a changing health care system. Advances in Nursing Science, 1988, 10, 22–34.CrossRefGoogle Scholar
2.Amchin, J., Perry, S., Manevitz, A., et al. Interview assessment of critically ill patients regarding resuscitation decisions: A case study in ethics research. General Hospital Psychiatry, 1989, 11, 103–08.CrossRefGoogle ScholarPubMed
3.Baier, S., & Schomaker, M. Z.Bed number ten. Boca Raton, FL: CRC Press, Inc., 1985.Google Scholar
4.Bandman, E. L.Our toughest questions-Ethical quandaries in high tech nursing. Nursing and Health Care, 1985, 6, 483–87.Google ScholarPubMed
5.Bayer, R., Callahan, D., Fletcher, J., et al. The care of the terminally ill: Mortality and economics. New England Journal of Medicine, 1983, 309, 1490–94.CrossRefGoogle Scholar
6.Barger-Lux, J. M., & Heaney, R. P.For better and worse: The technological imperative in health care. Social Science and Medicine, 1986, 22, 1313–20.CrossRefGoogle ScholarPubMed
7.Beauchamp, T. L., & Childress, J. F.Principles of biomedical ethics. New York: Oxford University Press, 1983.Google Scholar
8.Berenson, R. A.Intensive care units (ICUs): Clinical outcomes, costs, and decisionmaking (Health Technology Case Study 28). Washington, DC: Office of Technology Assessment, 1984.Google Scholar
9.Bouvia v. County of Riverside. No. 159780, Sup.Ct., Riverside Co., CA, Dec. 16, 1983, Tr.1238–1250.Google Scholar
10.Broyard, A.Doctor talk to me. New York Times Magazine, August 26, 1990, 35–37.Google Scholar
11.Cassell, E.Autonomy in the intensive care unit: The refusal of treatment. Critical Care Clinics, 1986, 2, 27–40.CrossRefGoogle ScholarPubMed
12.Crenshaw, R.Technical zeal or therapeutic purpose-How to decide? Journal of the American Medical Association, 1983, 250, 1857–59.Google Scholar
13.Cruzan v. Director, Missouri Dept. of Health. U.S. Supreme Court, June 25, 1990, No. 88–1503.Google Scholar
14.Daly, B. J., Rudy, E. B., Thompson, K. S., & Happ, M. B.Development of a special care unit for chronically critically ill patients. Heart & Lung, 1991, 20, 45–51.Google ScholarPubMed
15.Danis, M., Patrick, D. I., Southerland, L. I., & Green, M. L.Patient and family preferences for medical intensive care. Journal of the American Medical Association, 1988, 260, 797–802.CrossRefGoogle ScholarPubMed
16.Dracup, K., & Marsden, C. Critical care nursing: Perspectives and challenges. In Chaska, N. (ed.), The nursing profession: Turning points. St. Louis, MO: The C. V. Mosby Company, 1990, 304–12.Google Scholar
17.Ellul, J.The technological society. New York: Vintage Books, Division of Random House, 1964.Google Scholar
18.Emanuel, E. J.A review of the ethical and legal aspects of terminating medical care. The American Journal of Medicine, 1988, 84, 291–301.CrossRefGoogle ScholarPubMed
19.Fuchs, V. R.Who shall live? Health, economics, and social choice. New York: Basic Books, 1974.Google Scholar
20.Hay, D., & Oaken, D.The psychological stresses of intensive care unit nursing. Psychosomatic Medicine, 1972, 24, 109–18.CrossRefGoogle Scholar
21.High, D. M.Who will make health care decisions for me when I can't? Journal of Aging and Health, 1990, 2, 291–309.CrossRefGoogle ScholarPubMed
22.Holland, J., Sgroi, S. M., Marwit, S. J., & Solkoff, N.ICU syndrome: Fact or fancy. International Journal of Psychiatric Medicine, 1973, 4, 241–49.Google ScholarPubMed
23.Howard, J. Humanization and dehumanization of health care. In Howard, J. & Strauss, A. (eds.), Humanizing health care. New York: John Wiley & Sons, 1975, 57–102.Google Scholar
24.Jonsen, A. R.What does life support support? The Pharos, 1987, 50(Winter), 4–7.Google ScholarPubMed
25.Kass, L. R.Toward a more natural science. New York: The Free Press, 1985.Google Scholar
26.Knaus, W. A., Zimmerman, J. E., Wagner, D. P., et al. APACHE-Acute physiology and chronic health evaluation: A physiologically based classification system. Critical Care Medicine, 1981, 9, 591–94.CrossRefGoogle ScholarPubMed
27.Lubitz, J., & Prihoda, R.The use and cost of Medicare services in the last two years of life. Health Care Financing Review, 1984, 5, 117–31.Google Scholar
28.Luce, J. M.Ethical principles in critical care. Journal of the American Medical Association, 1990, 263, 696–700.CrossRefGoogle ScholarPubMed
29.Macklin, R.Mortal choices: Ethical dilemmas in modern medicine. Boston, MA: Houghton Mifflin Company, 1987.Google Scholar
30.Maguire, D. C.The moral choice. Minneapolis, MN: Winston Press, Inc., 1979.Google Scholar
31.Marik, P. E.Myocardial infarction prognostic scoring system. Heart & Lung, 1991, 20, 16–19.Google ScholarPubMed
32.Marsden, C.Ethical issues in critical care: Who should decide? Heart & Lung, 1990, 19, 687–89.Google ScholarPubMed
33.Mechanic, D. Impending ethical dilemmas in the allocation of health care services. In Mechanic, D. (ed.), From advocacy to allocation. New York: The Free Press, 1986, 206–24.Google Scholar
34.Mott, P. D.The elderly and high technology medicine: A case for individualized, autonomous allocation. Theoretical Medicine, 1990, 11, 95–102.CrossRefGoogle ScholarPubMed
35.Mott, P. D.New law requires hospitals to ask about living wills. Medical Ethics Advisor, 1991, 7, 1–2.Google Scholar
36.Nolan, K.In death's shadow: The meanings of withholding resuscitation. Hastings Center Report, 1987, 17, 9–14.CrossRefGoogle ScholarPubMed
37.Office of Technology Assessment. Life-sustaining technologies and the elderly (OTA-BA-306). Washington, DC: U.S. Government Printing Office, 1987.Google Scholar
38.President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Deciding to forgo life-sustaining treatment. Washington, DC: U.S. Government Printing Office, 1983.Google Scholar
39.President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Securing access to health care. Washington, DC: U.S. Government Printing Office, 1983.Google Scholar
40.Ramsey, P.The patient as person. New Haven, CT: Yale University Press, 1970.Google Scholar
41.Robin, E. D.A critical look at critical care. Guest editorial. Critical Care Medicine, 1983, 11(2), 144.Google Scholar
42.Starr, T. J., Pearlman, R. A., & Uhlmann, R. F.Quality of life: Resuscitation decisions in elderly patients. Journal of General Internal Medicine, 1986, 1, 373–79.CrossRefGoogle ScholarPubMed
43.Sorenson, J. H.Ethics and technology in medicine: An introduction. Theoretical Medicine, 1990, 11, 81–85.CrossRefGoogle Scholar
44.Tisdale, S.The sorcerer's apprentice, medical miracles, and other disasters. New York: Henry Holt and Co., 1986.Google Scholar
45.Wanzer, S. H., Federman, D. D., Adelstein, S. J., et al. The physician's responsibility toward hopelessly ill patients: A second look. New England Journal of Medicine, 1989, 320, 844–49.CrossRefGoogle ScholarPubMed
46.Wolpe, P. R.The holistic heresy: Strategies of ideological challenge in the medical profession. Social Science and Medicine, 1990, 31, 913–23.CrossRefGoogle ScholarPubMed
47.Younger, S. J.Patient autonomy, informed consent, and the reality of critical care. Critical Care Clinics, 1986, 2, 41–51.CrossRefGoogle Scholar