In public ICUs, where resources are often limited and patient demand is high, triage decisions typically adhere to strict utilitarian principles-prioritizing individuals with the greatest likelihood of survival and long-term benefit. To allocate scarce resources fairly and efficiently, triage frameworks commonly consider factors such as resource intensity, patient frailty, and the potential reversibility of the acute illness. However, these criteria have been criticized for systematically disadvantaging certain populations-particularly elderly patients and those with underlying malignancies-who may be perceived as having poorer prognoses, often without sufficient consideration of individual clinical variability.
In contrast, private ICUs may apply different triage approaches, shaped by greater resource availability, institutional discretion, and, at times, the financial capacity of patients or families. This divergence raises important ethical concerns about equity, consistency, and access to care across different healthcare settings.
This session uses the application of ECMO in elderly and cancer patients as a case study to examine how differing triage philosophies in public versus private sectors influence clinical decision-making, patient outcomes, and ethical considerations.
