Ethical Considerations in the Use of Technology in the Cardiac Intensive Care Unit

This chapter addresses some of the ethical issues related to the tremendous technological progress in medicine in general, and in cardiology in particular. It starts with the crucial but difficult distinction between utility and futility of technology as well as the question of when to start and when to stop treatment. These issues go to the ethical core of medicine, i.e., to do good and avoid doing harm. Given the vast potential of modern technology, there are ample chances of futile diagnostics and treatment, and modern medicine is extensively charged with doing too much and thereby violating the principles of beneficence, non-maleficence, and justice. The extensive potential of technology also spurs hype, hope, and hubris. To counterbalance such effects and to bar inappropriate technology use in cardiac intensive care units (as in health care in general), I argue, we need to identify and address the drivers of excessive technology use. “External” drivers of inappropriate use are related to stakeholders and their roles while “internal” drivers are identified as biases and imperatives in human beings, and both can undermine autonomy. We need to reflect on and avoid the negative effect of these drivers of medical technology in order to use technology and its great potential to help people in an appropriate way.