Emotional decision for accepting patients in the ICU in Greece – where are the guidelines?

Abstract

Introduction

It is not a rare phenomenon to ask a bed in the ICU in a basis of emergency. Then, the answer coming from the intensivists may be more than surprising. Objective of our study is to highlight the fact that emotional reasons and not medical criteria are the dominant ones for accepting a patient in the ICU.

Methods

We present 4 cases of interest.

Results

A poor Russian 75-year-old man with gastric cancer, anemia and haemodynamic instability was not accepted in the ICU with the oral and not written rejecting answer that he suffers from advanced cancer. A 35-year-old transplanted patient with bone marrow, fever, severe lactic acidosis, was not accepted in the ICU for hours because the intensivist would give her consent only if the patient would undergo a cholecystectomy first! The intensivist was a pneumonologist! In the end multiple liver abscesses were discovered, so an operation would not help. An 80-year-old man operated for colon cancer with haemodynamic instability was accepted in the ICU without delay. A 72-year-old with colon cancer, cachexia, thrombopenia and severe dementia, coming from the Psychiatric Hospital where he remained for months, was accepted in the ICU without delay.

Conclusions

If there is not an Ethics Commitee to examine these unexpectability matters concerning patients needing a place in ICU, then a psychiatric evaluation of Intensive Unit physicians might help, for the good of patients. Would a member of the Parliament or a celebrity receive a “No” from the ICU?

Disclosure of interest

The authors have not supplied their declaration of competing interest.