Table 3 Items to be considered in the construction of the screening protocol

• Make an extensive review of the literature.

• Examine the existing ethical structures.

• Provide a basis for the chosen ethical structures.

• Define inclusion criteria.

• Establish complementary or non-clinical criteria.

• Combine point systems and mortality predictors, which should be validated, clear, and objective, in intensive therapy.

• Define a prioritization score

• Establish reevaluation periods.

• Use a multiple principle prioritization structure.

• Enable the participation of stakeholders (specialists, clinicians, decision makers, and society) in the definition of the ethical structure and clinical, non-clinical, and tiebreaker criteria.

• Establish tiebreak criteria.

• Define alternative treatments/options for those who will not benefit from the resource.

• Develop specific guidelines for children.

• Pay attention to the usability of the screening instrument.

• Develop an algorithm for the screening instrument.

• Make the established screening policy and criteria public.

• Periodically update the protocol.