Proportionality and the process of decision-making around ICU admission: A narrative review of the ethical complexities of navigating from “can” to “ought”
Authors' conclusion
Moral case deliberation as an example of a clinical ethics approach shows promise as an education tool and a way to build decision-making capacity and trust between ICU and other clinicians. Proportionality is a suitable approach to framing benefit and weighing competing tensions.
Study context
- Population
- Literature on ICU admission decision-making and clinical ethics, January 1, 2005 to January 1, 2025
- Outcome
- Sources of ethical tension around ICU admission decision-making
Methodological detailsnarrative synthesis, Search of Ovid Medline, CINAHL and PubMed, plus reference lists; further review of bioethics literature
- Narrative synthesis
- Search of Ovid Medline, CINAHL and PubMed, plus reference lists; further review of bioethics literature
Main finding
As reported in the abstract
- Clinical ethics approaches used to understand ethical tension and improve ICU admission decision-making
- Clinicians' difficulty weighing benefits and burdens of treatments a potentially modifiable deficit
- Proportionality more appropriate than futility or rescue imperatives to frame value of ICU admission
- Uncertainty an important modifiable contributor to decision-making challenges
Original publication
Proportionality and the process of decision-making around ICU admission: A narrative review of the ethical complexities of navigating from “can” to “ought”. J Crit Care. Published 19 January 2026. doi:10.
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