Reduction of ethical dilemmas presupposes solid medical knowledge. Ethical crisis often occur because of medical uncertainty. Unless we know the effect of therapy and the outcomes of each disease process advising families and society on the appropriate distribution of the resources required for critical care is a guessing game. This ambiguity hinders and even prevents ethical resolution.

Intensivists must provide this technologically sophisticated, life enhancing care in an economically responsible fashion. The national environment mandates solutions to this medical challenge in a market environment. This is a critical challenge to childrens critical care medicine.