Respiratory failure in the patient with AIDS: is critical care warranted?

The issue of whether or not the life-sustaining treatments (LST) of critical care is warranted for patients with the acquired immunodeficiency syndrome (AIDS) experiencing acute respiratory failure has been raised. Factors that have contributed to this issue include the AIDS epidemic, the high costs of critical care, limited intensive care resources, high mortality, prolonged suffering, and the effects on caregivers in delivering futile care. This article examines this issue from the ethicality of the decision-making process regarding LST in context with medical futility, patient autonomy, and discussion among patients and caregivers. The allocation of critical care resources for AIDS patients with respiratory failure is analyzed from the viewpoint of distributive justice. The nursing implications of providing critical care to these patients and their families are discussed as well as needed areas of research.