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Resource allocation in ICU

ethical considerations

McGuire, Andrew; McConnell, Paul C.

Current Opinion in Anesthesiology: April 2019 - Volume 32 - Issue 2 - p 190–194
doi: 10.1097/ACO.0000000000000688
ETHICS, ECONOMICS AND OUTCOME: Edited by Hartmut Buerkle

Purpose of review Increasing scarcity of resources on the background of ever improving medical care and prolonged life expectancy has placed a burden on all aspects of health care. In this article we examine the current problems with resource allocation in intensive care and question whether we can find guidance on appropriate resource allocation through ethical models.

Recent findings The problem of fair and ethical resource allocation has perpetually plagued health care. Recent work has looked at value for money, benefits of therapies and how we define futility, but these still fall victim to the same problems that classical schools of ethical thought have tried to tackle.

Summary Many ethical principles provide a framework on which to allocate resources to certain cohorts of patients, however, most appear too rigid to be fully and primarily utilized for intensive care admission. We suggest a collaboration of principles be applied to achieve a moral, ethical and common sense approach to this issue. Over resourcing and under resourcing is also suggested to be problematic for patients and healthcare workers alike.

Department of Anaesthesia and Intensive Care Medicine, Royal Alexandra Hospital, Paisley, UK

Correspondence to Paul C. McConnell, MB ChB (Hons) FRCA EDIC FFICM, Royal Alexandra Hospital, Corsebar Road, Paisley PA2 9QF, UK. Tel: +0141 314 6609; e-mail:

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