Question

The director of the intensive care unit (ICU) is called to consult on an 80-year-old patient with advanced metastatic disease who visited the emergency department with hypotension and sepsis. His decision not to admit the patient to an ICU bed should be based on which of the following ethical principles?

1) Justice
2) Futility
3) Nonmaleficence
4) All of the above

Answer 1

The ICU director's decision not to admit an elderly patient with advanced metastatic disease to an ICU bed should be based on the ethical principles of justice, ensuring fair and equitable use of healthcare resources, futility, acknowledging that ICU care may not be beneficial, and nonmaleficence, avoiding harm to the patient through unnecessary interventions.

Step-by-step explanation:

The director of the intensive care unit (ICU) is called to consult on an 80-year-old patient with advanced metastatic disease who visited the emergency department with hypotension and sepsis. His decision not to admit the patient to an ICU bed should be based on the ethical principles of justice, futility, and nonmaleficence.

Justice refers to the equitable distribution of healthcare resources, ensuring that patients are treated fairly in similar circumstances. The principle of futility pertains to the likelihood that the ICU care will not improve the patient's outcome, particularly when procedures may not change the ultimate prognosis of a terminal illness. Nonmaleficence focuses on not causing harm to patients, which includes avoiding interventions that lack a clear benefit and may prolong suffering.

In this scenario, the ICU director's decision encompasses evaluating the potential benefit or harm that ICU admission would provide to a patient with advanced metastatic disease, the equitable use of limited ICU resources, and the preventable sufferings such as invasive procedures that would not likely offer a significant extension or improvement in quality of life.