ICU Resource Allocation in the New Millennium: Will We Say “No”?

Excerpt

This book is the third in a thought-provoking series edited by Dr. Crippen, Professor of Critical Care Medicine at the University of Pittsburg.1 The first book in the series dealt with international perspectives on the treatment of critically ill patients at the end of life.2 The second book discussed communication with patients and families at the end of life from various cultural viewpoints.3 For this current offering, Dr. Crippen has brought together authorities in the fields of critical care medicine, law, nursing, and bioethics from around the world to address some fundamental questions: How do we continue to deliver critical care in the setting of limited resources? Can or should we prioritize access to care? The assumptions are all well known to critical care physicians. Health care is a costly resource that represents an ever increasing expenditure; however, health care funding has slowed over the past few years in response to the global financial crisis. This is balanced against ever increasing expectations from patients and families for access to novel and expensive technologies and treatments. This is particularly true for intensive care where we are faced with an aging population and are willing to treat conditions previously deemed fatal. …