Ethics in the intensive care unit. Creating an ethical environment.

This article discusses ethical issues that exist each and every day in interactions with patients, families, and fellow workers in the ICU, even in the absence of overt conflict or controversy. The creation of an ethical working environment in the ICU is a necessary precondition for dealing with the ethical issues raised by specific issues such as cardiopulmonary resuscitation, the limitation or withdrawal of life-sustaining treatment, the special care of children with disabilities, brain death, and organ procurement, and triage. The creation of an ethical working environment requires developing a collaborative relationship with patients, families, staff, and other health care professionals.