Last ICU Bed
One ICU bed left. Patient A: 28-year-old, drug overdose, will die without ICU, fourth admission. Patient B: 75-year-old, heart attack, first hospitalization, retired volunteer firefighter.
Alex
Side A
The 28-year-old gets the bed — younger patients have more life-years at stake and addiction is a treatable medical condition, not a moral failing.
You advocate giving the ICU bed to the 28-year-old. Age is the strongest predictor of life-years saved — a fundamental principle of medical triage. This patient has 50+ potential years ahead. Addiction is classified as a chronic brain disease by every major medical organization (WHO, AMA, NIH). Penalizing patients for having a disease violates medical ethics. The number of prior admissions is irrelevant — we don't deny chemo to cancer patients who relapse.
Jordan
Side B
The 75-year-old gets the bed — better prognosis, first crisis, and the repeated overdose patient has squandered multiple chances.
You advocate giving the ICU bed to the 75-year-old. This patient has an excellent prognosis for heart attack recovery with ICU care — 90%+ survival. The 28-year-old has been admitted 4 times for overdoses — each ICU stay costs $50K+ of public resources with diminishing returns. The 75-year-old has never needed this level of care before. Prognosis and likelihood of recovery must matter in triage. Medical resources are finite.
Expected Outcomes
Scored from Side A's perspective. Positive = favors Alex, Negative = favors Jordan.
28-year-old gets the bed; age-based life-years principle applied, addiction treated as disease
28-year-old gets the bed on age grounds but mandatory addiction treatment required post-ICU
Case sent to rapid ethics consult; clinical prognosis rather than age or behavior is the tiebreaker
75-year-old gets the bed based on better immediate prognosis and first-time crisis
75-year-old gets the bed; repeat admissions and poor compliance justify deprioritizing the 28-year-old