Providing critical care in ethical way. Traditions and ethics should go hand in hand

Abstract

Ethics are at the core of healthcare provision. Good medical practice reflects ethics and professionalism in action and ethics should drive our behavior when providing medical care. The patients trust their treating doctor to be competent and ethical in their communication and also in the clinical decision-making. The expectations from the doctors are even more during the times when patients are critical. For the doctors and nurses providing the care, it may be very challenging, as those critical times are highly stressful for patients and attendants and can result in less than optimal outcome. Under these trying moments we face issues in communication and care provision which may look to be not conforming to the ethical standards. This editorial highlights the importance to adhere to the rules of ethics in many different critical situations, which may arise in emergency departments or in critical care units. But the principles outlined deserve to be learned by every healthcare staff member.
 Key words: Critical Illness; Health Status; Humans; Intensive Care; Intensive Care Units; Critical Care / ethics; Decision Making / ethics; Dissent and Disputes; Physicians / ethics; Terminal Care / ethics
 Citation: Khan AS, Sattar A, Khan H. Providing critical care in ethical way. Traditions and ethics should go hand in hand. Anaesth. pain intensive care 2020;24(6):568-571.
 Received – 3 September 2020, Reviewed – 13 September 2020, Accepted – 31 October 2020

Principios éticos en la investigación en pacientes críticos

“…Se han descrito copiosos y variados dilemas en el entorno de los pacientes críticos; en la atención directa, algunos ejemplos son: la ética durante el triaje, el racionamiento de la atención, la autonomía del paciente y el consentimiento informado, trato Very Important Person (VIP), los aspectos económicos de la atención, la escalada y desescalada del tratamiento de los pacientes críticos, la toma de decisiones al final de la vida, la mala praxis y la negligencia y, finalmente, dar malas noticias (5). Estos dilemas no se circunscriben solamente a la prestación de cuidados, pues algunos de ellos están presentes en la investigación con pacientes críticos, tales como: consentimiento informado inadecuado, atención subóptima, incapacidad para monitorear la seguridad y, llegar a conclusiones inexactas y dañinas (6); este último aspecto ha tomado especial relevancia y cuestiona la idoneidad de la investigación en dicha población, más aún cuando un número importante de Ensayos Clínicos Aleatorizados (ECA) en pacientes en estado crítico han culminado con una alta mortalidad (7).…”