This book addresses the ethical problems that physicians have to face every day while caring for critically ill patients. Advances in medical technology, ageing societies worldwide, and their increased demands on health care systems have, on the one hand, led to better care and remarkable longevity in many parts of the world. On the other hand, however, improved treatments in many medical fields, amongst others in emergency and critical care, have resulted in more patients surviving with reduced quality of life. This entails tradeoffs for many patients, their families, and the teams caring for them. At the same time, health care expenditures have risen dramatically and have to be balanced against costs for other public goods. Finally, the humane aspects of care have often failed to keep pace with the remarkable technological strides made in recent years. In this book, experts in their respective fields describe compelling ethical challenges resulting from these discrepancies and discuss potential solutions. The book is primarily intended for clinicians who care for two of the most vulnerable patient subpopulations – those being treated in ambulances or emergency rooms, and those being treated at intensive care units – due in part to the fact that they may be temporarily or permanently incapacitated. Core medical skills, such as diagnosis and predicting outcomes, as well as implementing treatment, remain challenging. However, without adequate communication and collaboration both within the inter-professional treatment teams and between the teams and the patients/their families, delivering excellent care is difficult at best. Therefore, the so-called “soft skills” are given the attention they deserve in order to overcome the gap between technological progress and interpersonal standstill.

The expense of critical care and emergency medicine, along with widespread expectations for good care when the need arises, pose hard moral and political problems. How should we spend our tax d'ollars, and who should get help? The purpose of this volume is to reflect upon our choices. The authors whose papers appear herein identify major difficulties and offer various solutions to them. Four topics are discussed throughout the volume: First, encounters between patients and health professionals in critical situations in general, and where scarcity makes rationing necessary; second, allocation and social policy, including how much to spend on preventive, chronic or critical care medicine, or for medicine in general compared to other important social projects; third, conflicts between or ranking of important goals and values; and fourth, conceptual issues affecting the choices we make. Since these topics are raised by the authors in almost every essay, we did not divide the papers into separate sections within the volume. Warren Reich begins the volume with a parable illustrating a key problem for contemporary medicine and two very different approaches to its solution. His story begins with the "delivery" of three indigent, critically ill, foreign patients to the emergency room of a large American private hospital. Although the hospital is legally bound to care for these patients, providing long term, high cost care for them and others soon becomes a major financial strain.

In this book, part of the European Society of Intensive Care Medicine (ESICM) textbook series, experts in the field of clinical ethics describe basic principles of clinical ethics and ethical reasoning, the fundamental pillars of intensive care medicine as well as the decision-making processes necessary to arrive at appropriate decisions for each individual patient. Specifically, the complex decision-making process, with regard to limiting life-sustaining therapies and integrating palliative care into intensive care, are expounded. Furthermore, the still controversial topics of ethical climate, proportionate care, and prioritization are elaborated upon. The so-called “soft skills” of inter-professional communication and co-operation are given the attention they deserve in order to overcome the gap between technological progress and interpersonal standstill. Finally, widely accepted ethical values and principles were challenged by the Covid-19 pandemic, forcing clinicians to elaborate recommendations regarding the prioritization of scarce resources. The book will be an invaluable tool for clinicians to understand ethical principles and reasoning to contend ethical challenges in intensive care medicine across the boundaries of disciplines and professions, in order to provide an appropriate individual plan of treatment for their patients.

The most engagingly written, clinically relevant overview of the practice of anesthesiology Hailed as the best primer on the topic, Morgan and Mikhail’s Clinical Anesthesiology has remained true to its stated goal: “to provide a concise, consistent presentation of the basic principles essential to the modern practice of anesthesia.” This trusted classic delivers comprehensive coverage of the field’s must-know basic science and clinical topics in a clear, easy-to-understand presentation. At the same time, it has retained its value for coursework, review, and as a clinical refresher. Key features that make it easier to understand complex topics: Rich full-color art work combined with a modern, user-friendly design make information easy to find and remember Case discussions promote application of concepts in real-world clinical practice Boxed Key Concepts at the beginning of each chapter identify important issues and facts that underlie the specialty Numerous tables and figures encapsulate important information and facilitate recall Up-to-date discussion of all relevant areas of anesthesiology, including equipment and monitors, pharmacology, pathophysiology, regional anesthesia, pain management, and critical care

Critical Issues in Homeland Security: A Casebook encourages analytical and careful examination of practical homeland security problems through the presentation of contemporary cases involving major state or national events. Case studies demonstrate the complexity of challenges within the domain of homeland security policy and administration. Editors James D. Ramsay and Linda Kiltz carefully curated fourteen cases, all from top scholars and practitioners, to cover a broad range of legal, policy, and operational challenges within the field of homeland security. Timely and interesting cases on such issues as arctic security, the use of drones in targeted killings, cyber security, and the emergency management lessons of the 2010 Haiti earthquake give students a deeper understanding of the relationship between the theories and the practices of homeland security. Discussion questions at the end of each case and an online instructor's manual make Critical Issues in Homeland Security an even more effective learning tool for any homeland security program.

This issue of Emergency Medicine Clinics, guest edited by Drs. Michael K. Abraham and Evie Marcolini, focuses on Neurologic Emergencies. This issue is one of four selected each year by series Consulting Editor, Dr. Amal Mattu. Topics include: Traumatic injuries of the nervous system; Modern Neuroimaging Techniques in Diagnosing TIA and Acute Ischemic Stroke; Neurologic Emergencies at the Extremes of Age; Headache in the Emergency Department Avoiding Misdiagnosis of Dangerous Secondary Causes and Infections of the Central Nervous System.

Here's the innovative new problem-based book which explains the practical guidelines on the management of the critically ill child, from presentation in the emergency room through to transfer to the pediatric intensive care unit. Written by experts, this user-friendly text has excellent features such as boxes of key points outlining common errors in management, tips on best practice, and even sections on controversial care. Also includes coverage of background physiology and epidemiology to assist the process of understanding and diagnosing the pathology of childhood critical illness and injury.

This book is designed to consolidate the relevant literature as well as the thoughts of professionals currently working in the field into a practical and accessible reference for the emergency medical technician, student, nurse, resident, and attending emergency physician. Each chapter is divided into four sections: case presentation, discussion, review of the current literature, and recommendations. Designed to serve simultaneously as a learning and reference tool, each chapter begins with a real case that was encountered in an ED setting. The case presentation is followed by a short discussion of the case, as if at a morbidity and mortality conference, by a panel of experienced attending physicians explaining how they would approach the ethical dilemmas associated with the case, and a review of the existing literature.

This issue of Critical Care Clinics focuses on Obstetric and Gynecologic Emergencies in the ICU. Articles include: Respiratory Failure and Mechanical Ventilation in the Pregnant Patient, Anesthetic Complications in Pregnancy, Neurologic Complications in Pregnancy, Renal Failure in Pregnancy, Management Complex Cardiac Issues in the Pregnant Patient, Liver Failure in Pregnancy, Hypertensive Emergencies in Pregnancy, Ethical Issues in Pregnancy, and more!

This book examines the issue of ethics in the context of the provision of military health care in an epidemic. Outbreaks of epidemics like Ebola trigger difficult ethical challenges for civilian and military health care personnel. This book offers theoretical reflections combined with reports from recent military and NGO missions in the field. The authors of this volume focus on military medical ethics adding a distinct voice to the topic of epidemics and infectious diseases. While military health care personnel are always crucially involved during disaster relief operations and large-scale public health emergencies, most of the current literature treats ethical issues during epidemics from a more general perspective without taking into account the specifics of the military context. The contributions in this volume provide first-hand insights into some of the ethical issues encountered by military health care personnel in missions during the Ebola outbreak in 2014/2015. This practical perspective is complimented by academic analyses and theoretical reflections on ethical issues associated with epidemics. This book will be of much interest to students of military studies, ethics and African politics.