Critical care: Why there is no global bioethics

The high technology and the costs involved in critical care disclose the im plausibility of applying the American standard version of bioethics in the developing world. The American standard version of bioethics was framed dur ing the rapid secularization of the American culture, the emergence of a ne w image for the medical profession, the development of high technology medi cine, an ever greater demand in resources, and a shift of focus from famili es and communities to individuals. This all brought with it a particular id eology of health care which promised Americans (1) the best of care, (2) eq ual care, and (3) physician/patient choice, without (4) runaway costs. This essay argues that this moral project is impossible in practice. This impos sibility is especially salient in developing countries. In addition to the fact that it is financially impossible to provide all in the developing wor ld with the standard of care accepted by law, policy, and convention in dev eloped countries, different moral perspectives with different orderings of values will seem more or less plausible in different cultures. Indeed, such an approach would be harmful. A concrete bioethics applicable across the w orld does not appear possible.