Ethical Issues in Critical Care


Ethics plays a big role in critical care patients. The job of the director is to create ethical guidelines for the staff to follow when caring for patients. The role of the staff is to make sure that the decisions they make for their patients fall within these ethical guidelines while informing and supporting the family in any critical care decisions that must be made.

End-of-Life Issues

  • One of the most common topics in ethics for critical care staff is end-of-life issues. This topic is broad and can include withholding life sustaining treatments, respecting the wishes of the patient, and counseling the patient's family. The staff provides all the choices for patients and family members so they are fully informed before making any decisions.

Informed Consent

  • To avoid ethics violations, many critical care decisions must be accompanied by informed consent. Informed consent provides a structure of ethical principles for the hospital to follow when treatment is given. It outlines the type of treatment being given and the potential outcomes. This document provides liability protection for the hospital.

    Informed consent can be given by a patient that has his or her full capacity for making a decision. If the patient is a minor or deemed not able to make his own decisions, informed consent can be obtained by proxy consent from a legal guardian, next of kin, or designated health care surrogate.

Management Decisions

  • Ethical issues also exist outside of the clinical ICU setting in many hospitals. Nurse managers and unit directors also have to consider ethical issues when creating policies for health care employees and protocols for keeping the employees, as well as the patient, safe. Directors and managers must understand where they draw the ethics line in order to make these decisions in policy.

    Directors must also consider where any incoming resources should be allocated, which can cause controversy if the decision does not appear to benefit the patient in some way.

Access to Critical Care

  • Another ethical issue in some health care facilities is the population's access to critical care. Critical care staff need to be trained in assessing the most critical cases and providing sufficient medical care for patients who may recover.

Teaching Ethics

  • Directors and managers of ICU units have several ethics teaching options. One of the most effective ways of teaching nurses and doctors how to handle ethical situations is to use case studies. Case studies are presented to the staff, who must recognize the ethical issues and make decisions based on the needs of the patient and her family.


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