Table 4.

How the balance may alter as the facts and the outcomes of relevance change

	Facts and outcomes of relevance
Last bed	Delayed discharges are present in ICU.	A patient can be discharged from ICU a day earlier than planned.	Admission would require another patient to be transferred to another hospital.
Certainty of prognosis and potential to benefit	Middle-aged patient with perceived devastating brain injury and no other significant medical history	Middle-aged patient with life-limiting lung disease and now with devastating brain injury	Bed bound, nursing home, octogenarian, with devastating brain injury
Communication	Family all present and accepting the prognosis	Family not all present, but delayed for 4–8 h	Family not accepting the prognosis