An ethical challenge in critical care: The severely injured patient

Concurrent with the enormous advances in critical care medicine, an immense literature has evolved extolling the notions of patient autonomy and death with dignity as curbs on the inappropriate pursuit of such new opportunities. The new ethos of patient autonomy has a great deal of merit. It also lacks clinical nuance and realism in certain types of cases. This yields inappropriate clinical results and unethical management. This article argues for a form of therapeutic activism that this new ethos seems to condemn. This activism is especially appropriate for certain types of severely injured patients.