ICU Governance

Existing governance systems may not transfer readily to LMICs because they often rely on strong institutional, legal, and administrative infrastructure. ICU governance consists of institutional mechanisms that structure ethical deliberation, accountability, documentation, oversight, and resource allocation in critical care. ICU governance includes formal and informal systems for admission, treatment limitation, family communication, specialist involvement, and justification of difficult decisions. Governance mechanisms in high-income countries include ethics committees, ethics consultation services, triage policies, and structured palliative care consultation pathways.