The rationing of intensive care

Meeting the challenges of allocating critical care resources in the fairest way possible depends upon the development of a standardized strategy for apportioning ICU services in times of limited supply. Two main approaches are emerging to handle these challenges. The first, rationing, requires the development of specific guidelines for determining ICU admission and discharge policies. The second approach involves improving the efficiencies of the care giving system itself. Either approach requires the establishment of a standard of care that reduces the potential for personal biases into the decision making process.