Ethical Decisions and Dilemmas in the ACS Patients Requiring ICU:Understanding When to Start and When to Stop

The major goal of intensive care units (ICUs) is to offer patients optimal management that will ensure survival and quality of life in accordance with their wishes and values . With the advances in medicine and technology, ICUs have now the capacity to treat patients who would have previously not been expected to survive and would therefore not have been managed in ICUs. In recent decades, advances in medical technology have afforded intensivists a remarkable ability to extend life, even in the setting of critical illness [3]. This has led to extensive ICU utilization at the end of life, with an estimated one in five Americans admitted to the ICU prior to death . Moral dilemmas and challenges of end-of-life care surrogate decision-making and potentially futile interventions arise frequently when caring for critically ill patients [5].