I was pretty sure a goodly portion of ICU admissions were the result of trauma - certainly the first article mentions several gunshot-wound patients at Sinai-Grace as well as the Austrian girl, and I don't know if the limo driver would've ended up in the ICU if his surgery hadn't gone pear-shaped and given his behavior they wouldn't've gotten permission for, well, much of anything at the time he got there (so no prevention of that line infection for him). That's assuming getting permission is as easy as getting a form signed - I'm pretty sure there's more to it than that (like keeping track of the forms and making sure you do use checklists for signers and don't for non-signers).
But now I find myself thinking that in this case the protocol of ethics is getting in the way of actual ethics (particularly the doctor's creed of "do no harm"). Plus if it happens that trauma ICU patients tend more often to be minorities while non-trauma ICU patients tend to be white. . . things could get *really* messy, especially if it's as effective as it seems to be.
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Date: 2008-02-16 04:26 pm (UTC)But now I find myself thinking that in this case the protocol of ethics is getting in the way of actual ethics (particularly the doctor's creed of "do no harm"). Plus if it happens that trauma ICU patients tend more often to be minorities while non-trauma ICU patients tend to be white. . . things could get *really* messy, especially if it's as effective as it seems to be.