Penn Study Shows the "Rule of Rescue" Often Prevails in Critical Care UnitsJULY 11, 2011
High stakes life and death decisions are made every day by doctors and nurses in critical care units, but increasingly critical care clinicians are also tasked with containing costs and managing scarce resources in light of rising demands for and costs of care they provide. Physicians are often asked to consider limiting services for their patients to benefit society more broadly. Now, a new study from the Perelman School of Medicine at the University of Pennsylvania indicates that the so-called "rule of rescue" -- whereby clinicians are prone to try to save their own patients as opposed to opening up a bed for a new patient -- often prevails even in the face of substantial social benefit in terms of cost containment and procurement of organ donations. "Our study suggests that many intensive care unit (ICU) clinicians are prone to provide salvage critical care for identifiable patients with grave prognoses even when doing so measurably contravenes society's interests," said Scott Halpern, MD, PhD, MBE, assistant professor of Medicine and Epidemiology, and senior author of the study, which appears in Intensive Care Medicine. "Adherence to this 'rule of rescue' accords with traditional norms for clinicians of prioritizing one's own patients, but contrasts with recent conceptualizations of medical professionals' social responsibilities."