title: [Rationing, prioritisation, rationalizing: Significance in everyday intensive care].
abstract: BACKGROUND
  Rationing, even in the treatment of critically ill patients, is the reality on intensive care units. Severity of illnesses and urgency of care are posing high ethical barriers for explicit cost-saving orders. Nevertheless, implicit rationing decisions are a daily ethical minefield, which is not always appreciated by healthcare providers.
  
  
  METHODS
  In this article, typical decision-making situations are described, where limitation of resources plays a role.
  
  
  RESULTS
  The idea of saving resources by rationalising rather than rationing results from the fact that not every patient benefits from the full scope of services available in the intensive care unit, and not every patient desires the full scope of care to be supplied to them. Thus, the irrational use of resources can sometimes be avoided to save them for cases where they are necessary.
authors.affiliation: Institut für Anästhesiologie, Intensivmedizin und Schmerztherapie, Allgemeines Krankenhaus Viersen, Hoserkirchweg 63, 41747, Viersen, Deutschland. gretenkort@akh-viersen.de.
authors.forename: P
authors.initials: P
authors.lastname: Gretenkort
mesh_terms: D003422:Critical Care / Q000941:ethics / Q000458:organization & administration*; D016638:Critical Illness; D004992:Ethics, Medical; D005858:Germany; D015276:Health Care Rationing / Q000941:ethics / Q000458:organization & administration*; D006292:Health Priorities / Q000941:ethics / Q000458:organization & administration*; D006801:Humans; D009313:National Health Programs / Q000941:ethics / Q000458:organization & administration*; D040841:Resource Allocation / Q000941:ethics / Q000458:organization & administration; D013727:Terminal Care / Q000941:ethics / Q000458:organization & administration
keywords: End of life care; Ethical issues; Prognosis; Resource allocation; Triage