Ethical Issues in Neurocritical Care

By definition, ethics is a branch of philosophy dealing with values pertaining to human conduct, considering the rightness and wrongness of actions, the goodness or badness of the motives and ends of such actions. Ethics in medicine may be considered as the process of resolving moral issues through reason and mutual respect rather than by force and violence. Ethics is an inherent part of medicine, more so in neurological illness as the patients have impaired ability to make decisions regarding their treatment options and life. The physicians face several dilemmas in the neurointensive care unit, and it is the moral obligation of the team to make sure the right path is chosen. All over the world, several guidelines, resolutions, and laws have been passed for the ICU physicians and moral code of ethics laid down. It is expected that the clinician will always follow the principle of “do no harm” and his decisions will be in the best interest of the patient, utilising the best possible resources available. Healthcare providers should therefore be knowledgeable not only about how and when to use therapies, but also about when it is ethically appropriate to withhold or withdraw them. End-of-life decision-making can be a source of miscommunication and conflict between the family and ICU physician.