Country/setting | Guiding principles | Target patients | Prioritization criteria | Decision-making process | Implementation conditions |
---|---|---|---|---|---|
1. Austria [40] | Ethical principles of justice, beneficence, well-being, autonomy | All patients needing critical care | Comorbidities | Decision-maker: intensive care specialist Process: consultation with designated experts and patients and relatives Time of decision-making: – | Health resource demand exceeds supply |
2. Belgium [11] | First come, first served Randomization | All patients needing critical care | First-come, first served; medical urgency; cognitive impairment; patient age; comorbidities | Decision-maker: Team of healthcare professionals Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner Time of decision-making: upon admission with daily reassessment | Health resource demand exceeds supply |
3. Germany [12] | Clinical success | All patients needing critical care | Comorbidities | Decision-maker: team of healthcare professionals Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner Time of decision-making: upon admission | Health resource demand exceeds supply |
4. Italy [23] | Greatest life expectancy | All patients needing critical care | Patient age; Comorbidities | Decision-maker: healthcare staff with patients, proxies + others (ethics committees) Process: consultation with designated experts and patients/relatives Time of decision-making: upon admission with daily reassessment | Health resource demand exceeds supply |
5. Switzerland [9] | Beneficence Non-maleficence Respect for autonomy Equity | All patients needing critical care | Patient age; comorbidities | Decision-maker: team of healthcare professionals Process: consultation with ethics committee/team Time of decision-making: upon admission with reassessment every 2–3 days |  |
6. United Kingdom (NHS) [10] | Clinical success | All patients needing critical care | Clinical frailty; comorbidities | Decision-maker: team of healthcare professionals Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner Time of decision-making: upon admission |  |
7. United Kingdom (BMA) [41] | Promote safe and effective patient care as far as possible in the circumstances | All patients needing critical care | Â | Decision-maker: team of healthcare professionals Time of decision-making: upon admission | Â |
8. United States (Hastings Center) [42] | Promote equality and equity in distribution of the risks and benefits in society | All patients needing critical care | Â | Decision-maker: healthcare staff with patients, proxies and others (ethics committees) Process: consultation with designated experts and patients/relatives Time of decision-making: upon admission | Â |
9. United States (New York) [24] | Save the most lives | All patients needing critical care | First come, first served; randomization; social usefulness; patient age; comorbidities; Sequential Organ Failure Assessment | Decision-maker: nominated triage officer or triage committees Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner Time of decision-making: upon admission with reassessment after 48 and 120 h | Health resource demand exceeds supply |
10. United States (Pittsburgh) [25] | Duty to care Duty to steward resources to optimize population health Distributive and procedural justice Transparency | All patients needing critical care | Patient age; comorbidities | Decision-maker: nominated triage officer or triage committees Process: consultation with designated experts Time of decision-making: upon admission | Health resource demand exceeds supply |
11. International (WHO) [43] | Utility and equity, on the basis of health-related considerations | All patients needing critical care | Â | Decision-maker: intensive care specialist Time of decision-making: upon admission | Health resource demand exceeds supply |