Ah. Morris et al., ETHICAL IMPLICATIONS OF STANDARDIZATION OF ICU CARE WITH COMPUTERIZEDPROTOCOLS, Journal of the American Medical Informatics Association, 1994, pp. 501-505
Citations number
50
Categorie Soggetti
Information Science & Library Science","Medicine Miscellaneus","Computer Science Information Systems
Ethical issues related to the use of computerized protocols to control
mechanical ventilation of patients with Acute Respiratory Distress Sy
ndrome (ARDS) are identical to the ethical issues surrounding the use
of any therapy or intervention. Four ethical principles must be consid
ered: nonmaleficence, beneficence, autonomy, and distributed justice.
The major ethical challenges to computerized protocol use as a specifi
c application of clinical decision support tools are found within the
principles of nonmaleficence and of beneficence. The absence of credib
le outcome data on which ARDS patient survival probabilities with diff
erent therapeutic options could be based is a constraint common to mos
t ICU clinical decision making. Clinicians are thus deprived of the kn
owledge necessary to define benefit and are limited to beneficent inte
ntion in clinical decisions. Computerized protocol controlled decision
making for the clinical management of mechanical ventilation for ARDS
patients is ethically defensible. It is as well supported as most ICU
therapy options.