Significant improvements in care result in prolonging the life of patients with heart diseases. On the other hand, however, it is not uncommon for a cardiac intensive care physician to be faced with the need to decide not to initiate or to discontinue intersive treatment.
In addition, acute situations can be reversed in a number of heart diseases and the patient converted to a chronic stage of disease; however, over time, all treatment options become gradually exhausted and an increasing number of individuals live to reach irreversible end-stage disease in which treatment fails and it is necessary to prepare for its termination. All of this presents new ethical and legal problems for decision-making.