P Gretenkort1. 1. Institut für Anästhesiologie, Intensivmedizin und Schmerztherapie, Allgemeines Krankenhaus Viersen, Hoserkirchweg 63, 41747, Viersen, Deutschland. gretenkort@akh-viersen.de.
Abstract
BACKGROUND: Rationing, even in the treatment of critically ill patients, is the reality on intensive care units. Severity of illnesses and urgency of care are posing high ethical barriers for explicit cost-saving orders. Nevertheless, implicit rationing decisions are a daily ethical minefield, which is not always appreciated by healthcare providers. METHODS: In this article, typical decision-making situations are described, where limitation of resources plays a role. RESULTS: The idea of saving resources by rationalising rather than rationing results from the fact that not every patient benefits from the full scope of services available in the intensive care unit, and not every patient desires the full scope of care to be supplied to them. Thus, the irrational use of resources can sometimes be avoided to save them for cases where they are necessary.
BACKGROUND: Rationing, even in the treatment of critically illpatients, is the reality on intensive care units. Severity of illnesses and urgency of care are posing high ethical barriers for explicit cost-saving orders. Nevertheless, implicit rationing decisions are a daily ethical minefield, which is not always appreciated by healthcare providers. METHODS: In this article, typical decision-making situations are described, where limitation of resources plays a role. RESULTS: The idea of saving resources by rationalising rather than rationing results from the fact that not every patient benefits from the full scope of services available in the intensive care unit, and not every patient desires the full scope of care to be supplied to them. Thus, the irrational use of resources can sometimes be avoided to save them for cases where they are necessary.
Entities:
Keywords:
End of life care; Ethical issues; Prognosis; Resource allocation; Triage
Authors: U Janssens; H Burchardi; G Duttge; R Erchinger; P Gretenkort; M Mohr; F Nauck; S Rothärmel; F Salomon; P Schmucker; A Simon; H Stopfkuchen; A Valentin; N Weller; G Neltzke Journal: Med Klin Intensivmed Notfmed Date: 2013-02 Impact factor: 0.840