The increasing complexity of modern hospital care and the decisions that must be made were the reasons we began our research on the Acute Physiology, Age and Chronic Health Evaluation project. As a clinician in an intensive care unit, I felt very uncomfortable making the sorts of decisions that are common today without any source of information or any reference points. These decisions are not avoidable, they are not discretionary, and they are going to become more frequent in the future (...) because we are treating people at later stages of disease. (shrink)

The shape, function, and dynamic of the field of bioethics is in constant flux, and nowhere is this more apparent than at gatherings of those immersed in th discipline. This section presents coverage and commentary on conferences and settings where voices out-side the mainstream of biomedical ethics can be heard.

In the United States, at least 6% of all hospital beds are in the intensive care unit or coronary care unit. The cost of treating a patient in an intensive care unit averages from $2,000 to $3,500 per day. At least 10–40% of intensive care patients will not survive to hospital discharge. Today, every major category of disease may be found in the modern ICU; common diagnoses are septicemia, postsurgical complications, cerebrovascular accidents, gastrointestinal bleeding, neoplasia, and respiratory failure. ICUs employ (...) some of the most sophisticated medical technology, routinely monitoring the cardiopulmonary performance of patients and often providing assisted ventilation. ICUs are high intensity in terms of their staffing, involving 24-hour physician supervision and nurse:patient ratios from 1:3 to 1:1. (shrink)