A transcultural, preventive ethics approach to critical-care medicine: Restoring the critical care physician's power and authority

Journal of Medicine and Philosophy 23 (6):628 – 642 (1998)
Laurence McCullough
Baylor College of Medicine
This article comments on the treatment of critical-care ethics in four preceding articles about critical-care medicine and its ethical challenges in mainland China, Hong Kong, Japan, and the Philippines. These articles show how cultural values can be in both synchrony and conflict in generating these ethical challenges and in the constraints that they place on the response of critical-care ethics to them. To prevent ethical conflict in critical care the author proposes a two-step approach to the ethical jus tification of critical-care management: (1) the decision to resuscitate and initiate critical-care management, which is based on the obligation to prevent imminent mortality without permanent loss of consciousness; and (2) the decision to continue critical-care management, which is based on the obligation both to prevent imminent death without permanent loss of consciousness and to avoid unnecessary, significant iatrogenic costs to the patient and psychosocial costs to the family when the reduction of morta lity risk is marginal. Physicians and hospitals should restore the critical-care physician's authority and power - against prevailing cultural values, if necessary - to control when critical-care intervention is offered, when it is recommended to continue, and when it is recommended to be discontinued and the patient allowed to die.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1076/jmep.23.6.628.2559
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 36,555
Through your library

References found in this work BETA

No references found.

Add more references

Citations of this work BETA

No citations found.

Add more citations

Similar books and articles

Critical Care: Why There is No Global Bioethics.Tristram H. Engelhardt Jr - 1998 - Journal of Medicine and Philosophy 23 (6):643 – 651.
Ethical Challenges in Critical Care Medicine: A Chinese Perspective.Yali Cong - 1998 - Journal of Medicine and Philosophy 23 (6):581 – 600.


Added to PP index

Total downloads
11 ( #506,501 of 2,303,257 )

Recent downloads (6 months)
1 ( #430,305 of 2,303,257 )

How can I increase my downloads?

Monthly downloads

My notes

Sign in to use this feature