Creating compassionate care within the hospital intensive care unit: beyond positivism and toward wisdom and responsibility

Abstract

Of deaths in the US, an increasing proportion occur within hospital intensive care units amidst miraculous medical technology. A positivist ethos dominates, despite the severe philosophic criticisms levelled at its axiomatic foundations. As patients are transformed into ‘cases’, they lose social identity, and their dying becomes a medical defeat, rather than a natural and social process. Families encounter sedated intubated specimens rather than social persons from whom they wish ceremonially to depart. In response to these problems, there are ongoing efforts at transformation and remediation. Viewing biomedicine in relationship to phronesis, this article explores the dilemmas.