Determining ethical criteria for admissions to a rehabilitation unit: a survey of senior rehabilitation physicians

Abstract

Background/Aims There is great demand for the beds in the new rehabilitation department in the authors' hospital. To determine ethical criteria for admission to the department, all senior rehabilitation physicians in the country were surveyed regarding their willingness to admit patients in various ethical scenarios. The aim was to determine whether there are consensus ethical principles governing whom to admit to the limited beds. Methods The survey was administered to senior medical personnel responsible for admissions decisions. Out of the 54 people contacted, 30 completed the surveys (all were fully completed apart from one survey in which one clinical scenario was not answered). Results Over 90% of respondents agreed to not admit non-compliant patients or to give precedence to those who were considered to be very important people, and 88% agreed on admitting a homeless patient. First come, first served was not considered an important criterion. Cronbach's alpha was <0.6. There was no consensus on most of the issues presented. Conclusions It remains difficult to pinpoint what rehabilitation physicians consider ethical ‘givens’. This research suggests that no specific ethical principle underlying the triage decisions in rehabilitative medicine can be discerned. Larger studies are warranted. Implications for practice No ethically or specific principle underlying the triage decisions in rehabilitative medicine can be discerned. What one doctor may consider a clear ethical decision another physician may not concur.