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Clinical Practice Fundamentals FCCS FDM HDM PACEP PACT PICU RICU Systems Cardiac End of Life Hematology Neurology Nutrition Renal Respiratory Infection Research Publications Quality and Safety Quality ICU REPORT and Index Quality Tips Success Stories Patient Safety Safety Tips Specialty Survey Rapid Response Systems Administration Administrative Guidelines Toolbox Professionalism Teamwork Ethics Quick Links Site Map Ethics is a field that has special interest for the critical care professional, as the intensive care unit (ICU) is the site of many ethical controversies. Indeed, the recent needs assessment by the American College of Critical Care Medicine (ACCM) indicated that individual practitioners have many questions about ethics issues in their everyday practice. The ACCM Ethics Committee serves the College and all critical care professionals by addressing the special ethical issues related to care for critically ill and injured patients. Additional information on ACCM Ethics Committee activities is available on the SCCM Web site, here. Resources for professionals and the public on end-of-life care are provided on the EOL page, one of the Clinical Practice resources on LearnICU Critical Care Ethics: A Practice Guide from the ACCM Ethics Committee Critical Care Ethics: A Practice Guide is now available in print. To submit questions for future revisions of the guide, visit the ACCM Ethics Committee's Practice Guide page. Browse the table of contents and access chapters as PDF files on this page (below), or order from the SCCM online catalog. In an effort to help with some of the many questions individual practitioners have about ethics issues, the Ethics Committee prepared this practical guide, presented in a question and answer format. Individual chapters are published online monthly to help distribute this information as widely as possible. SAMPLE CHAPTERS Each chapter in the practice guide is framed as a question, and includes a concise answer complete with suggestions for further reading. The full table of contents is listed below; the chapter currently available in PDF format is marked in bold. PDF files may be downloaded for personal use. A new chapter will be available each month. TABLE OF CONTENTS What are the ethical principles I need to know? How can I organize the process of making ethical decisions? What do I need to know about understanding "advance directives" versus "living will" versus "healthcare proxies"? What is the difference between withholding and withdrawing therapy? What is "euthanasia" and how is this distinguished from "withdrawing of therapy", "assisted suicide", and "homicide"? Who should make decisions if there is no family? Who signs the consent for research in the ICU? What should I know when dealing with an observant religious family? What do I do when a patient is a Jehovah's Witness or Christian Scientist and is refusing some aspects of my recommended care? Are there differences for a child? Available as a PDF file here. What is the persistent vegetative state and is it different from brain death? Am I as a clinician required to provide therapy that I find to be unethical? How do we deal with the patient who asks for nontraditional, complementary, or alternative care therapies? How can I help with conflict resolution between members of the healthcare team and the patient's family? Why is food and hydration given by "artificial means" considered to be something that can be withdrawn or foregone? How do we manage and control pain at the end of life? What is the "rule of double effect"? How does futility fit into discussions at the end of life? How do I use a hospital ethics committee? What are some of the legal cases important to ethics in the ICU? What unique pediatric and neonatal considerations need to be addressed? What resources do you recommend to learn about medical ethics and about bioethics? Ethics - Ethics Home

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