Rationing in the intensive care unit

• DOI: 10.1097/ccm.0b013e31822d750d
• Publication Date: 2011-10-04T22:53:33Z
• Authors: Michael J. Young; Sydney E. S. Brown; Robert D. Truog; Scott D. Halpern
• Keywords: Rationing; Health care rationing

Growing pressures to ration intensive care unit beds and services pose novel challenges clinicians. Whereas the question of how allocate scarce resources has received much attention, whether disclose these decisions patients surrogates not been explored.We explore considerations professionalism, dual agency, patients' surrogates' preferences, beneficence, healthcare efficiency efficacy influence propriety disclosing rationing in unit.There are compelling conceptual reasons support a policy routine disclosure. Systematic disclosure prevailing norms for making allocation decisions, at least most consequential specific can promote transparent, professional, effective delivery. However, many empiric questions about best structure implement processes remain be answered. Specifically, research is needed determine operationalize so as maximize prospective benefits minimize burdens on clinicians units.