Clinical ethics at bedside in Intensive Care Unit: what difference does ethics consultation make?

摘要

I ntensive care is by its very nature a branch that works at the very boundaries of medicine, and which necessarily involves tackling highly complex situations whose ethical implications are extremely convoluted and often dilemmatic. Examples of these are issues such as triage and admission to the Intensive Care Unit (ICU), consent to treatment, proportionality of treatment, end-of-life choices, limitation and suspension of life support treatments, research and experimentation in the non-competent or pediatric subject, resource allocation, organ donation after diagnosis of death with neurological or cardiovascular criteria, and so forth. In this context, clinical ethics consultation (i.e. ?a service provided by an individual or a group to help patients, families, surrogates, health care providers, or other involved parties address uncertainty or conflict regarding value-laden issues that emerge in health care?)1 can undoubtedly be a valuable aid and the article by Picozzi et al.2 published in this issue of Minerva Anestesiologica provides an interesting perspective.