Difficulties in Providing Intensive Care

¹ Children's Hospital of Philadelphia and University of Pennsylvania, School of Medicine, Philadelphia

The results of a pilot project investigating the feelings, attitudes, and behavior of physicians working in a pediatric intensive care unit are presented. With recent technologic advances in our capacity to help patients suffering from catastrophic illness, various segments of American society have become concerned about the unrestricted use of medical science. Questions have arisen about the economic costs, long-term medical out-come, emotional costs to patients and families, legal problems, and ethical implications of "heroic" therapy. By contrast, we have asked relatively few questions about the social processes involved in providing intensive care. We know little about the emotional and functional responses of the physicians in critical care facilities, and their decision making processes remain obscure. This investigation evolved from the conviction that environments comprised of sophisticated medical technology and extensive life support systems pose pressing problems for those working and learning in them.