Who should get the last PICU bed?

Pediatrics. 2014 May;133(5):907-12. doi: 10.1542/peds.2013-3369.


Administrators sometimes face ethical dilemmas about the allocation of institutional resources. One such situation is when elective surgery cases require reserved ICU beds and the ICU is full. Such situations arise frequently in children's hospitals today. They are sometimes complicated by questions about whether every patient in the ICU belongs there. We present such a situation and responses from Mark Del Becarro, Vice President for Medical Affairs at Seattle Children's Hospital; Aaron Wightman, a nephrology fellow and bioethicist at Seattle Children's Hospital; and Emily Largent, a doctoral student in the joint JD/PhD Program in Health Policy at Harvard University.

Keywords: ethics; futility; justice; rationing; resource allocation.

MeSH terms

  • Child
  • Ethics, Medical*
  • Health Care Rationing / ethics
  • Health Services Accessibility / ethics*
  • Health Services Accessibility / organization & administration*
  • Hospitals, Pediatric
  • Humans
  • Intensive Care Units, Pediatric / ethics*
  • Intensive Care Units, Pediatric / supply & distribution*
  • Medical Futility
  • Needs Assessment / ethics*
  • Resource Allocation / ethics*
  • Washington