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. This article outlines major events in the history of ethics and law in the ICU, covering the evolution of ICUs, ethical principles, informed consent and the law, medical decision-making, cardiopulmonary resuscitation, withholding and withdrawing life-sustaining therapy, legal cases involving life support, advance directives, prognostication, and futility and the allocation of medical resources. Advancement of the ethical principle of respect for patient autonomy in ICUs increasingly is in conflict with physicians' concern about their own prerogatives and with the just distribution of medical resources.
Publication types
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Historical Article
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Legal Case
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Research Support, N.I.H., Extramural
MeSH terms
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Advance Directives / history
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Advance Directives / legislation & jurisprudence
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Bioethics / history
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Cardiopulmonary Resuscitation / ethics
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Cardiopulmonary Resuscitation / history
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Critical Care / ethics*
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Critical Care / history*
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Critical Care / legislation & jurisprudence
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Female
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History, 20th Century
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Humans
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Informed Consent / history
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Informed Consent / legislation & jurisprudence
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Intensive Care Units / ethics
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Intensive Care Units / history*
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Intensive Care Units / legislation & jurisprudence*
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Life Support Care / ethics
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Life Support Care / history
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Life Support Care / legislation & jurisprudence
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Medical Futility / ethics
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Medical Futility / legislation & jurisprudence
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Resource Allocation / ethics
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Resource Allocation / history
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Resource Allocation / legislation & jurisprudence
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Terminal Care / ethics
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Terminal Care / history
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Terminal Care / legislation & jurisprudence
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United States
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Withholding Treatment / ethics
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Withholding Treatment / history
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Withholding Treatment / legislation & jurisprudence
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Young Adult