Ethical issues in resuscitation and intensive care medicine

Le M Rustom, Christopher T.; Palmer, James; Thomas, Gareth L.

doi:10.1016/j.mpaic.2009.11.001

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Volume 11, Issue 1 , Pages 1-5, January 2010

Ethical issues in resuscitation and intensive care medicine

Christopher T Le M Rustom MRCP is a final year medical student at Manchester University, UK. He has an MSc in Health Care Ethics and Law. Conflicts of interest: none declared

James Palmer BSc MB ChB FRCA is a consultant Anaesthetist at Salford Royal NHS Foundation Trust, UK. Conflicts of interest: none declared

Gareth L Thomas BMedSci(Hons) MBBS MRCP FRCA EDIC is a consultant in Intensive Care Medicine at Salford Royal NHS Foundation Trust, UK. Conflicts of interest: none declared

Abstract

Both legal and ethical issues may be encountered by intensive care practitioners on a regular basis. A keen knowledge of the law and of professional guidelines will assist decision-making in challenging clinical cases. Four bioethical principles can be utilized in ethical dilemmas to provide a framework upon which to base moral decisions. Being able to assess mental capacity and ascertain a patient's best interests are both key requisites for the intensive care practitioner. The application of these principles to common scenarios is discussed.

Keywords: autonomy, DNAR, ethics, futility, intensive care, organ donation, rationing, restraint, resuscitation