The World Federation of Societies of Intensive and Critical Care Medicine (WFSIC- CM) has reached the age of maturity. Physicians, nurses, and many others associated with the field of Intensive and Critical Care Medicine will be coming from all corners of the world to Florence, Italy in August, 2009 to celebrate the 10th quadrennial congress. Every 4 years for the last 36 years, congresses in the magnificent venues of London (1973), Paris (1977), Washington (1981), Jerusalem (1985), Kyoto (1989), Madrid (1993), Ottawa (1997), Sydney (2001), and Buenos Aires (2005) have sig- fied an ever-developing process which has resulted in the four pillars of the field of Intensive and Critical Care Medicine, namely partnership, ethics, professionalism, and competence. The first pillar is based on a stronger interdisciplinary collaboration and a mul- professional partnership in the field of Intensive and Critical Care Medicine. In recent decades, professional activity in medicine has been regulated by well-defined, universal principles, such as the welfare of the patient, autonomy, social justice, and the patient-physician relationship. The second pillar, ethics, has offered welcomed assistance to all these principles in establishing an ethics curriculum.