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November 16, 1994

Rationing Intensive Care

Author Affiliations

East Carolina University Greenville, NC
Medical College of Wisconsin Milwaukee

JAMA. 1994;272(19):1481. doi:10.1001/jama.1994.03520190022014

To the Editor.  —We commend the Society of Critical Care Medicine Ethics Committee1 for its clear and insightful recent statement on the distribution of intensive care resources among individual patients. The statement rightly acknowledges resource scarcity and the subsequent potential for conflict between the value of intensive care for individual patients and other medical and nonmedical values, though it does not directly address the thorny question of how those competing values should be balanced. The statement also emphasizes the need for public disclosure of triage policies; we would add that the public should be given an opportunity to contribute to the formulation of such policies, at least in public hospitals. We agree with the committee that the concept of triage provides a better model for these decisions than the widely discussed concept of futility. Unlike futility, triage clearly connotes the evaluation of both benefits and burdens in a context

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