Agreed beforehand
Agreed in calm conditions: scope, availability and handover are settled before a critical situation arises.
Arrange this in advance+49 30 23125 470
In an emergency, call your local emergency number.
An intensive care physician at the bedside — for one patient, anywhere in the world.
On an intensive care unit, procedures take over five of the six conditions a life depends on.
The six conditions
aer
Air, water, season and place belong to the case: the Canon treats a person’s surroundings as medically effective conditions, not as a passive setting.
WHAT THEY TAKE OVER
VENTILATOR
motus et quies
The Canon pairs the two yet examines them separately: movement by force and duration, rest as cooling and moistening.
WHAT THEY TAKE OVER
POSITIONING THERAPY
somnus et vigilia
Sleep and waking stand in the Canon as one paired condition among six, alongside atmospheric air, food and drink, movement and rest, and emotions.
WHAT THEY TAKE OVER
ANALGESIA AND SEDATION
cibus et potus
The Canon sets out what a person is to eat and to drink in detail, down to the requirements a drinking water has to meet.
WHAT THEY TAKE OVER
CLINICAL NUTRITION
evacuatio et retentio
What has to leave the body and what has to stay in it: in the Canon that is one condition, not two.
WHAT THEY TAKE OVER
KIDNEY REPLACEMENT THERAPY
accidentia animae
Anger, joy, fear, grief, shame: the Canon places them within one of six conditions and describes how the pneuma moves outward or inward, suddenly or gradually in these states.
WHAT THEY TAKE OVER
The sixth has no device.
The mandate is to keep the whole situation in view — alongside the treating team.
A case is more than the sum of its readings.
When one condition cannot be delegated, the situation cannot be reduced to apparatus and values.
Ibn Sīnā (Avicenna), Canon of Medicine, Book I, before 1015 — six necessary causes. The Latin names come from the later Latin transmission.
ROLE AND SCOPE
I work without taking over treatment or issuing instructions to the team.
What I do
The sixth condition
- I ask about language, habits and what is familiar, and pass on what matters to the team.
- I follow alertness and orientation, and assess changes with a validated delirium screen.
- I speak to the patient under sedation, and agree a yes/no signal where speech is not possible.
- I check that day and night stay distinguishable, and that glasses and hearing aids are at hand.
- I take part in the family conversations and record questions, dissent and what stays open.
First 24 hours
- I clarify the situation, urgency and decision authority.
- I review records, findings, medication, directives and the team’s plan.
- I consult the team for an independent ICU assessment.
- We record: on-site assessment, coordination, or transportability and transfer.
Independence
I neither receive nor pay remuneration for recommendations.
No hospital, operator, assistance company or intermediary pays me.
Payment never depends on the outcome.
ROLE AND SCOPE
- Availability
- Window and deputy agreed in writing.
- Reach
- Case-specific, subject to authorisation and insurance.
- Languages
- Documented proficiency or a professional medical interpreter.
TWO OCCASIONS
Beforehand, or when the situation is already acute.
The critical case
For one clearly defined situation. Whether and within which limits a mandate is possible is clarified first.
Discuss the case