Living on the Edge of Possibility

The birth, expansion, and sustenance of critical care medicine as a specialty have often presented ethical challenges and dilemmas to health care workers in diverse settings. In addition to critical services being provided at the extreme end of a disease process, they are often in limited supply. The authors present patterns of inception and development of this crucial service as they have witnessed in rural Africa. Furthermore, they present the ethical challenges, both typical and unique, as they have experienced them in a tertiary referral center in Kenya.