Procon clinical debate Life support should have a special status among therapies, and patients or their families should have a right to insist on this treatment even if it will not improve outcome 英文参考文献.docVIP

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Procon clinical debate Life support should have a special status among therapies, and patients or their families should have a right to insist on this treatment even if it will not improve outcome 英文参考文献.doc

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Procon clinical debate Life support should have a special status among therapies, and patients or their families should have a right to insist on this treatment even if it will not improve outcome 英文参考文献

Available online /content/8/4/231 Review Pro/con clinical debate: Life support should have a special status among therapies, and patients or their families should have a right to insist on this treatment even if it will not improve outcome David Crippen1 and Laura Hawryluck2 1Clinical Associate Professor, Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Philadelphia, USA 2Assistant Professor, Critical Care Medicine, University Health Network, University of Toronto, Canada Corresponding author: David Crippen, crippen@ Published online: 19 February 2004 Critical Care 2004, 8:231-233 (DOI 10.1186/cc2823) This article is online at /content/8/4/231 ? 2004 BioMed Central Ltd Abstract Most hospitals are facing the dilemma caused by demand for critical care beds outstripping supply. This imbalance is likely to get worse over the coming years as a result of many factors, including aging of the population, improved technology, and improved therapies, among other factors. As a result we are likely to have to make further tough decisions about rationing of this service. In this issue of Critical Care, two authors debate the appropriateness of providing life support in accordance with a family’s wishes to an individual who is unlikely to survive admission to the intensive care unit. Understanding both sides of this debate is an important aspect of an intensivist’s job. Keywords critical care, end of life, futility, mechanical ventilation, treatment decisions The scenario You are called to the medical ward to see a patient who has patient, and the patient is unable to participate in decision making. On full review you also believe that the patient would not survive ICU admission, and although mechanical ventilation may prolong life it would not correct the underlying illness. You discuss everything with the patient’s family and they request ICU admission. You are uncertain about the ethics of providing life