Ross Perfetti

Intensive Care Units (ICUs) provide life-saving treatments to critically ill patients. At the same time, practices such as mechanical ventilation and heavy sedation can cause long-term emotional, physical, and cognitive impairments for patients. Accumulating research on these negative outcomes demonstrates a dual effect of biomedical progress and the harms incurred by high-tech healthcare. The emergent category of ‘Post-Intensive Care Syndrome’ describes these adverse biological effects as well as social pathologies, such as disruptions in memory and feelings of isolation among survivors. The criteria of this syndrome are continually revised in medical literature and clinical settings, yet the classification remains nebulous as the complex social formations of ‘ICU survivorship’ can evade categorization. How do clinicians and researchers make sense of medical harm that includes both biological and social effects? I will conduct 18 months of ethnographic research among ICU clinicians, patients, and families in clinics, homes, and rehabilitation centers. I examine how clinicians grapple with the multifaceted biological and social aspects of ICU survivorship and how classification shapes opportunities for accountability. This research illuminates how complex ethical formations, or what I call ‘syndromes of care,’ emerge at the frontiers of innovation and edges of medical knowledge.