Blending science and compassion: The 30th educational symposium of the Society of Critical Care Medicine, San Francisco, USA, 10-14 February 2001

Introduction This year’s symposium was dominated by two major themes. The first was the unveiling of the results of the phase II clinical trial on the use of recombinant human activated protein C (rhAPC) in the treatment of sepsis. For the first time in 30 years a major breakthrough has been achieved and the result is all the more welcome given that recombinant antithrombin III was recently shown to be of no use in the treatment of sepsis. The second major theme was the need to educate physicians in the nuances of patient outcome in the intensive care unit (ICU). For a long time the philosophy has been to treat the patient as an object to be repaired. Now, however, we have the ability to prevent death in the majority of cases, but to what end? Statistics from the USA show that about 20% of patients admitted to the ICU die there. The important point is that 70 to 90% of those deaths are the result of a conscious decision to withhold or withdraw treatment. The issues of quality of life after treatment, and at the end of life (in the ICU) were also discussed.