JAMA. 1994 Apr 20;271(15):1200-3.
The demand for medical services such as critical care is likely to often exceed supply. In the setting of these constraining conditions, institutions and individual providers of critical care must use some moral framework for distributing the available resources efficiently and equitably. Guidelines are therefore provided for triage of critically ill patients. There are several general principles that should guide decision making: providers should advocate for patients; members of the provider team should collaborate; care must be restricted in an equitable system; decisions to give care should be based on expected benefit; mechanisms for alternative care should be planned; explicit policies should be written; prior public notification is necessary. Patients who are not expected to benefit from intensive care, such as those with imminently fatal illnesses or permanent unconsciousness, should not be placed in the intensive care unit. Hospitals should assign individuals the responsibility of intensive care triage, and a committee should oversee the performance of this responsibility to facilitate the most efficient and equitable use of intensive care.
对重症监护等医疗服务的需求很可能经常超过供给。在这些限制性条件下，重症监护机构和个体提供者必须采用某种道德框架来高效且公平地分配可用资源。因此，提供了重症患者分诊指南。有几条应指导决策的一般原则：提供者应为患者代言；提供者团队成员应协作；在公平的体系中必须限制医疗服务；给予医疗服务的决策应基于预期益处；应规划替代医疗服务机制；应制定明确政策；必须事先向公众通报。预计无法从重症监护中获益的患者，如患有即将致命疾病或永久昏迷的患者，不应被安置在重症监护病房。医院应指定专人负责重症监护分诊，并且应由一个委员会监督这项职责的履行，以促进重症监护的最有效和公平使用。
