Civetta J M
Department of Surgery, University of Miami School of Medicine, FL.
Crit Care Med. 1992 Dec;20(12):1714-20.
Review of the history and accomplishments of the Society of Critical Care Medicine (SCCM) to determine appropriate directions for the future.
Historical documents of the SCCM, Critical Care Medicine, bioethics and healthcare financing literature, Instant Library of Quotations.
Identified (by the author) material containing specific statements concerning goals and objectives at the time of the founding of the SCCM and at intervals. Material supporting and criticizing predictive indices were identified and bioethical treatises concerning patient autonomy and quality-of-life decisions were chosen.
Presidential addresses of the first three SCCM presidents, material relevant to preservation of life and alleviation of suffering from bioethical and healthcare financing perspectives. Relevant quotations.
Initial goals and objectives were identified. Societal and economic factors changing critical care were analyzed for their effect on current and future SCCM directions and objectives.
The founding members set important goals for critical care and patient care, research, education, and organization. From a perspective of what was foreseeable, these goals have been accomplished to an admirable degree. The SCCM has responded to these goals by providing educational programs and fostering research, especially in its annual meetings and through the publication of guidelines in Critical Care Medicine. The SCCM members would do well to read the first three presidential addresses to experience the eloquence and foresight firsthand, particularly with respect to the founders' spirit, considerations of training, scope of care, humanism, organization and relations within and outside of critical care, integration of care, and development of the scientific process at the bedside. There have been major changes in society since the SCCM was founded: the maturation of the concept of patient's autonomy; recognition of quality-of-life values; healthcare financing; and legal and ethical aspects of care. The critical care profession in general, and the SCCM specifically, should seek to develop effective cost-containment strategies and severity of illness or predictive indices. The SCCM should also educate the professions with respect to ethical issues and provide information directly to the public, especially in the areas of advance directives and withholding and withdrawing care. Through these contributions, the SCCM can assume its proper leadership role within medicine, but, of greater importance, in society. In doing so, societal myths and misunderstandings of the capabilities, futility, role, and limitations of critical care can be corrected. The organization and structure of the SCCM are well developed to accomplish these ends. The SCCM leaders are both able and willing. The objectives seem reasonable and should be attainable.
回顾危重病医学会（SCCM）的历史与成就，以确定未来的合适方向。
SCCM的历史文献、《危重病医学》、生物伦理学及医疗保健筹资文献、《即时引语库》。
（由作者）确定包含有关SCCM创立时及各阶段目标与宗旨的具体陈述的资料。确定支持和批评预测指标的资料，并选取有关患者自主权及生活质量决策的生物伦理学论文。
SCCM前三任主席的主席致辞、从生物伦理学及医疗保健筹资角度看与维持生命和减轻痛苦相关的资料。相关引语。
确定最初的目标与宗旨。分析改变危重病护理的社会及经济因素对SCCM当前及未来方向与目标的影响。
创始成员为危重病护理、患者护理、研究、教育及组织设定了重要目标。从可预见的角度看，这些目标已在令人钦佩的程度上得以实现。SCCM通过提供教育项目及促进研究来响应这些目标，尤其是在其年会上以及通过在《危重病医学》上发表指南。SCCM成员最好阅读前三任主席的致辞，亲身感受其中的雄辩与远见，特别是关于创始人的精神、培训考量、护理范围、人文主义、危重病护理内部及外部的组织与关系、护理整合以及床边科学进程的发展。自SCCM成立以来，社会发生了重大变化：患者自主权概念的成熟；对生活质量价值观的认可；医疗保健筹资；以及护理的法律和伦理方面。总体而言，危重病护理专业，尤其是SCCM，应寻求制定有效的成本控制策略以及疾病严重程度或预测指标。SCCM还应就伦理问题对各专业进行教育，并直接向公众提供信息，尤其是在预先指示以及停止和撤销护理等领域。通过这些贡献，SCCM可以在医学领域，更重要的是在社会中发挥其应有的领导作用。这样做可以纠正社会对危重病护理的能力、无用性、作用及局限性的错误观念和误解。SCCM的组织和结构已得到充分发展以实现这些目标。SCCM的领导者既有能力又有意愿。目标似乎合理且应可实现。
