ETHICAL IMPLICATIONS OF STANDARDIZATION OF ICU CARE WITH COMPUTERIZEDPROTOCOLS

Citation
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
ISSN journal
10675027
Year of publication
1994
Supplement
S
Pages
501 - 505
Database
ISI
SICI code
1067-5027(1994):<501:EIOSOI>2.0.ZU;2-2
Abstract
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.