Reich W T
Am J Emerg Med. 1984 Nov;2(6):554-8. doi: 10.1016/0735-6757(84)90083-4.
A dominant characteristic of critical-care medicine today is the emergence of powerful institutions functioning within a framework of a noncoherent set of values and philosophical perspectives. Anyone who would assign a significant role to the philosophy of medicine for today's era must not simply account for the quandaries of critical-care medicine, but also attend to the antecedent values, conflicts, and absurdities that form the ethical issues, as well as the models of ethical response (market ethos, professional ethos, etc.) that indicate which moral principles might be relevant. These considerations form the new agenda for the philosophy of critical-care medicine. This broad philosophical task is an urgent one, for critical-care medicine is rapidly molding the moral dimensions of all of medicine.
当今重症医学的一个主要特点是，强大的机构在一套缺乏连贯性的价值观和哲学观点框架内运作。任何认为医学哲学在当今时代应发挥重要作用的人，不仅必须解释重症医学的困境，还必须关注构成伦理问题的先前价值观、冲突和荒谬之处，以及表明哪些道德原则可能相关的伦理回应模式（市场风气、职业风气等）。这些考量构成了重症医学哲学的新议程。这项广泛的哲学任务十分紧迫，因为重症医学正在迅速塑造整个医学的道德维度。
