Intensive care hospitalization: ethical aspects of decision-making

Abstract

Scarcity of resources in healthcare – an extremely relevant issue in universal healthcare systems – has motivated the emergence of several situations where one needs to establish prioritization criteria,
especially within the scope of regulation. Based on a bioethical perspective, this article discuss the decision-making process of coordinating physicians in a situation involving scarcity of resources – in this case, intensive care unit beds. This is a reflective theoretical study, based on the ethical analysis of a hypothetical problem-situation involving the choice of patient for admission in this unit, in a context of a limited vacancies. The situation presented was assessed based on the principlist and utilitarian bioethical perspectives. The reflection emphasized that decisions of this nature must be based on a deep articulation between technical and ethical criteria. After the analysis, we concluded that random selection would be the most feasible and fairest from a bioethical point of view.