Patients are admitted to ICU for advanced life support and monitoring, during active treatment of an underlying clinical condition. The clinical condition which has resulted in the patient needing critical care should be identifiable, acute and potentially reversible.
Admission for critical care is only appropriate if the patient can be reasonably expected to survive and receive sustained benefit in quality of life. An increasing requirement for organ support is not in itself a reason to admit a patient who is suffering their terminal illness, and who has no apparent avenue of recovery.
Even when there is an acute reversible component, the patient’s chronic health status (impairment of organ systems or physiological reserve) may significantly affect the patient’s ability to survive and benefit from an intensive care episode. This requires careful assessment, but should not be prejudiced by age or ethnicity.
A patients stated or written preference for or against intensive care must be taken into account. The role of relatives in the case of an incapacitated patient is to represent their understanding of what the patient would wish.