Clinical Research

Justice in Intensive Care: What Admission/Discharge Criteria are used by Intensive Care Practitioners in Turkey?


  • Aslıhan Akpınar
  • Nermin Ersoy

Received Date: 13.12.2010 Accepted Date: 18.02.2011 Turk J Anaesthesiol Reanim 2011;39(3):115-125


To assess the decision-making criteria for patient admission and discharge used by intensive care pro- fessionals in Turkey.

Materials and Methods:

This trial was conducted in three national congresses and also via e-mail using a selfadministered questionnaire between 2004 and 2007. The questionnaire, which included 20 criteria of medical and societal benefits and social worth, prepared by researchers. Correlations between importance attached to the criteria, and characteristics of the participants were analyzed by chi-square test and p<0.05 was accepted significant.


Of 364 participants 228 were physicians and 136 nurses, also 82.3 % of the physicians and 53.7 % of the nurses were participated in admission/discharge decisions in their units. Of these 70.9 % claimed that they made tria- ge decisions because of scarcity of resources. Medical benefit appeared to be the most important criteria. The impor- tance given to medical benefit criteria was affected by socio-demographic characteristics, and professional capabilities as well. More than 50 % of the participants (50.3 %) which the majority was physicians gave importance to a social benefit criteria as patient’s age (p<0.05). While 33.2 % them, mostly nurses, gave priority to patient’s self-assessment of his/her quality of life (p<0.05). In terms of societal benefit, most of ICU workers (54.4 %) emphasized contribution of the treatment to the scientific knowledge


Ethically, priority of the medical benefit criteria is appropriate for decisions of admission and dischar- ge. However, giving importance to patient’s age or contribution of the treatment to the scientific knowledge is not appropriate. Therefore, it has been concluded that the guidelines of triage need to be established. In addition, nurses who play dominant roles as defenders of patients’ rights, should take part in medical and ethical decision-making process.

Keywords: Medical ethics, intensive care, attitude of health personnel, social justice, health resources