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Ethics of allocating intensive care unit resources
P N Lanken1, P B Terry, M L Osborne
1Pulmonary and Critical Care Division, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA.
New Horizons (Baltimore, Md.)
|February 1, 1997
Summary
ICU clinicians need to understand distributive justice to fairly allocate scarce resources. Without clear societal consensus, resource allocation risks bias based on non-medical factors.
Area of Science:
- Medical Ethics
- Health Policy
- Critical Care Medicine
Background:
- Intensive Care Unit (ICU) clinicians frequently make resource allocation decisions.
- High ICU care costs necessitate difficult choices between increasing demand and financial constraints.
- Understanding distributive justice principles is crucial for informed participation in societal discussions on resource allocation.
Purpose of the Study:
- To emphasize the importance of distributive justice for ICU clinicians.
- To explore the complexities of fairness in allocating scarce and expensive healthcare resources.
- To examine how societal values influence healthcare resource distribution.
Main Methods:
- Review of ethical principles of distributive justice.
- Analysis of existing studies on ICU resource allocation during scarcity.
- Examination of societal values and their translation into allocation policies.
Main Results:
- ICU resource allocation decisions are complex, influenced by financial constraints.
- During scarcity, ICU admission often favors patients with higher illness severity.
- Concerns exist regarding discriminatory allocation patterns based on race or insurance status.
Conclusions:
- Egalitarian approaches to lifesaving resource allocation are likely most acceptable in the U.S.
- Political and economic factors can influence access to scarce ICU beds.
- Lack of societal consensus on resource allocation risks covert rationing based on non-medical characteristics.