Ethical and legal dilemmas in accessing critical care services

Abstract

There is a growing need for critical care services, with increasing demands due to demographic trends, technological advances, growing costs of standard care, unexpected surges in demand, and public expectations. With the practice of critical care medicine evolving so rapidly due to the ability to sustain lives indefinitely, patients are living longer in the intensive care unit (ICU). As a result, patients and caregivers are faced with difficult decisions, often based on differing opinions on the appropriate use of newly emerging, potentially life-sustaining, yet expensive interventions. When conflicting views are held, their resolution can place undue strain on families and caregivers. To help deal with these situations, some institutions have developed guidelines and policies to reflect best standards to help guide difficult decisions about limits to treatment. However, there is no consensus on the use of such guidelines and their application in practice. © 2007 Springer Science + Business Media Inc.