Ethical Decision-Making

The protocol identifies a gap between the existence of guidance and institutional capacity to operationalise it consistently in ICUs. ICU decisions are shaped by institutional procedures, legal expectations, cultural norms, documentation practices, and available clinical resources. Some LMICs, including India, have national or professional guidance for end-of-life decision-making and Do Not Attempt Resuscitation practices. ICU clinicians routinely face ethically complex decisions about life-sustaining treatment, prognosis, resource allocation, and family communication.