The interface of law and medical ethics in medical intensive care

The delivery of medical care in the intensive care setting is subject to various legal principles and processes, as well as important ethical precepts. This article outlines the basic medicine-law interface, explaining the concepts of medical jurisprudence and forensic medicine. It then provides fundamental information about the current American medical malpractice system, including a brief discussion of the elements of a medical malpractice claim, the public policy rationales and goals purportedly undergirding the system, and potential alternatives to the existing medical malpractice system in the United States. Recognizing that the challenge, in the entire range of intensive care as in other medical settings, is adhering in practice to ethical principles while at the same time trying to minimize the providers' possible exposure to legal risks, the article identifies a number of components to the art of delivering care ethically and effectively within a pervasive legal environment, as follows: interfacing positively with the institutional legal counsel and risk management departments; utilizing (as appropriate) clinical practice guidelines or parameters; and pursuing continuing medical-legal education.