Ethical dilemmas about intensive care for patients with AIDS.

AIDS presents ethical dilemmas about intensive care. Even with intensive care the outcome for patients with AIDS is poor. Care givers have no ethical or medical obligation to provide futile care. Decisions concerning competent patients should be made jointly by physicians and the informed patients themselves. For incompetent patients decisions should be made jointly by physicians and appropriate patient-surrogates in light of the previously expressed wishes of the patients. Care givers should encourage patients with AIDS to express their preferences about life-sustaining treatment in order to avoid dilemmas should these patients later become incompetent. The AIDS epidemic may force more explicit discussions about the allocation of limited health-care resources, such as intensive care. Such allocation decisions should not discriminate against patients with AIDS.