North Trent Critical Care Network

Written by Critical Care Four ethical issues loom over the study by Lieberman et al. [1] -the absence of informed consent, its being "non-interventional" in situations that typically call for life-saving interventions, the bias involved in doctors that study their own problematic practice and monopoly over ICU triage and ageism.We learn that the Israeli doctors in this study never make a "no-treatment" decision regarding patients in need of mechanical ventilation. However, they are complicit with botched standards of care for these patients, accepting without much doubt an ethos of "scarce resources" and poor managerial habits.The main two practical lessons to be taken from this study are that for patients in need of mechanical ventilation, compromised care is better than "intubation only when ICU is available" policy, and that vigorous efforts are needed in order to extirpate ageism.

Authors: Y Barilan

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