Can we afford open-ended ICU care? Yes we can, but ...

Can we afford open-ended ICU care? Yes we can, but ...

e question whether we can aff ord open-ended intensive care unit (ICU) care should be answered with ‘yes we can, but ...’ [1]. Th e discussion is polarized. Th e US system will crash because everybody is right when it comes to openended care, and in Europe endless care is prohibited or rationed. With polarization, we lose sight of the middle path, where truth and solutions usually are found. Th...

Ethics roundtable: 'Open-ended ICU care: Can we afford it?'

THE CASE The patient is a 27-year-old previously healthy male with a diagnosis of viral encephalitis with a lymphocytic pleocytosis on cerebrospinal fluid examination. For 3 months, he has been in status epilepticus (SE) on high doses of barbiturates, benzodiazepines, and ketamine and a ketogenic feeding-tube formula. He remains in burst suppression on continuous electroencephalography (EEG). H...

Yes we can, but do we?

In recent decades, a curious demographic phenomenon has emerged in US science. A high and increasing proportion of PhD students and postdocs, especially in the life sciences, are drawn from beyond the shores of North America. The reasons for this are undoubtedly complex. One factor is the widespread perception in the USA that a career in academic science is marked by low salaries, poor job secu...

Yes, We Can! (Should We?).

Advocacy: yes we can.

It is an honor and privilege to address you as president of the American Society for Clinical Investigation. For more than 100 years, this organization has represented the best of physician-scientists. Since it is now 2012, there is the possibility that this could be the last ASCI presidential address. But we will assume the Mayans miscalculated and that we should look to the future. With the A...