This is a complimentary chapter from the textbook, Critical Care Ethics: A Practice Guide, Third Edition, titled, "What Do I Need to Know About Rationing in the ICU?"
Bedside rationing in the ICU is a controversial topic, but it is unrealistic to deny it. To avoid discussion of this topic may allow for the more insidious aspects of this practice to be, at best, unexamined and, at worst, unjustly applied. This chapter discusses rationing, with an emphasis on ethical principles and practice. Rationing refers to the distribution of resources, and the application of justice to this practice implies that resources are distributed fairly. Most people would say that it is only fair to invoke the principle of justice (as opposed to the principles of autonomy, nonmaleficence, and beneficence) before you approach the patient’s bedside. Ideally, justice decisions should be mandated (and advertised) as policy by institutions and society prior to the individual clinician-patient interaction. Although this approach to rationing is both admirable and fair, it is also naive to assume that perfection can be achieved
Critical Care Ethics: A Practice Guide, explores thought-provoking ethical questions that critical care professionals must face in real-life situations.