Moderation and excess of critical care. How to practice reanimation in the Anthropocene ?

Abstract

Critical care is a product of the Anthropocene epoch. It is partly the result of theoretical knowledge acquired between 1750 and 1900, which stemmed from a transformation in the relationship between humans and nature during the 17th century, and partly due to the abundance in resources that emerged with the great acceleration of the 1950s. The development of critical care within an imaginary where continuous improvement in performance was seen as both possible and inherently beneficial, led to a form of excess, creating the impression that the limits of life could always be pushed further. However, alongside this, the proximity to death, the invasive nature of the provided care, and the limited number of beds sharpened the sense of moderation and prudence among critical care professionals. Thus, critical care physicians, accustomed to the tension between moderation and excessiveness, are well-positioned to be at the forefront of the ethical evolution imposed by the Anthropocene world, a one marked by ecological, economic, health and geopolitical fluctuations, that requires robustness over performance.