Emergency Physician Stewardship of Finite Resources

Revised June 2025, January 2019
Reaffirmed June 2013, October 2007 and October 2001
Originally approved January 1997

As an adjunct to this policy statement, ACEP has prepared a policy resource and education paper (PREP) titled “Resource Utilization in the Emergency Department: The Duty of Stewardship”


Emergency physicians have a responsibility to patients and society to be prudent stewards of the health care resources entrusted to them. To ensure the protection of patient interests under the constraints of limited resources, ACEP endorses the following:

• The best medical interests of the patient should be considered foremost in any clinical decision-making process.
• Criteria for appropriate use of limited resources should include, in the following order: (1) the urgency of the patient's medical condition; (2) the likely treatment benefit to the patient; (3) the likely burdens and costs of treatment to the patient; and (4) the impact on availability of resources to other patients and society.
• Emergency physicians should not allocate health care resources on the basis of a patient's ability to pay, contributions to society, past utilization of resources, or personal responsibility for their medical condition.