Reflections, October 2015

Globalization of disease with rapidly increasing technologic sophistication in multiple sites; wide diversity of pharmacologic availability and use; varying government regulation and evolution of practice; increasing recognition of multicultural prerogatives in end-of-life care and organ donation policies; reserve about overly enthusiastic integration and adoption of inadequately validated protocols; general availability of advanced resuscitative techniques with unknown long-term survival impact; and a variety of exciting, innovative, and promising interventions and support strategies must make the specialty vibrant; global; and, of necessity, more scrutinized by and responsible to societal and cultural prerogatives.