This course is based upon material published in the journal Critical Care the Clinics and is available as an open access article on Wiley online library.

 

Abstract: Because they provide potential benefit at great personal and public cost, the intensive care unit (ICU) and the interventions rendered therein have become symbols of both the promise and the limitations of medical technology. At the same time, the ICU has served as an arena in which many of the ethical and legal dilemmas created by that technology have been defined and debated. In this essay, we outline major events in the history of ethics and law in the ICU. We cover 10 areas: 1) the evolution of ICUs, 2) ethical principles, 3) informed consent and the law, 4) medical decision-making, 5)cardiopulmonary resuscitation, 6) withholding and withdrawing life-sustaining therapy, 7) legal cases involving life support, 8) advance directives, 9) prognostication, and 10) futility and the allocation of medical resources. We emphasize that advancement of the ethical principle of respect for patient autonomy in ICUs increasingly is conflicting with physicians concern about their own prerogatives and with the just distribution of medical resources.

 

This course on the ethics and law in the intensive care unit is useful for nurses, but also for social workers, psychologists, professional counselors, and chemical dependency counselors who work with clients in hospital settings. This course is appropriate for beginning, intermediate and advanced level practitioners who wish to develop their understanding of ethics and law in intensive care units. It may also be useful for licensed clinicians who require ethics course credits and are interested in learning more about intensive care units, informed consent, advanced directives and medical decision making.  

 

Authors: Luce and White

 

Learning Objectives: This course will provide the practitioner with detailed information regarding ethics and law in intensive care units. Specifically, a professional will:

·         Describe methods for medical decision making and advance directives

·         Identify legal issues as they apply to informed consent

·         Identify elements of the ethical principal of respect for patient autonomy

 

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