[Medical ethics : The pioneering role of critical care medicine]

The development of intensive care medicine started over more than 50 years. Effective organ system support for ventilation initially and subsequently for circulation, nutrition and renal function resulted in improved outcomes in patients with a variety of severe medical conditions. One of the unfortunate consequences of this development was that it did not allow dying or prolonged the dying process and without the possibility of recovery to a quality of life acceptable to the patients. The early realization of this dilemma ultimately led to broad ethical discussions concerning withholding and withdrawal of curative therapies in intensive care units, and introducing palliative care.