Emergency Physician Stewardship of Finite Resources

Reaffirmed by the ACEP Board of Directors June 2013, October 2007 and October 2001
Approved by the ACEP Board of Directors January 1997


As an adjunct to this policy statement, ACEP's Ethics Committee developed a Policy Resource Education Paper (PREP), Resource Utilization in the Emergency Department: The Duty of Stewardship.

In day-to-day clinical decision making, the emergency physician has dual responsibilities to patients and society to employ prudent stewardship, namely, the responsible use of available health care resources. To ensure the protection of an individual patient's interests under the constraints of limited resources, ACEP endorses the following.


  • The best medical interest of the patient should be foremost in any clinical decision making process.

  • Criteria for appropriate use of finite resources should include (1) urgency of the patient's medical condition; (2) likelihood, magnitude, and duration of medical benefit to the patient; (3) burdens and costs of care to the patient; and (4) cost to society.

  • Emergency physicians should not allocate health care resources on the basis of a patient's ability to pay, contribution to society, past use of resources, or responsibility for their medical condition.
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