Frailty goes viral: a critical discourse analysis of COVID-19 national clinical guidelines in the United Kingdom
Critical Public Health
; 33(1):116-123, 2023.
Article
in English
| ProQuest Central | ID: covidwho-2236333
ABSTRACT
This paper explores how the rationing of medical care for older people by frailty score was justified and operationalised in the UK during the COVID-19 pandemic. COVID-19 was expected to overwhelm the National Health Service (NHS) in the UK. In March 2020, the National Institute for Health and Care Excellence (NICE) published the ‘COVID-19 rapid guideline critical care in adults', which advised that clinicians use the Clinical Frailty Score (CFS) to inform decisions about which patients over the age of 65 should be offered ventilatory support. We present a Foucauldian Critical Discourse Analysis of this guidance and the supporting online resources. Analysis shows how the guidance merchandises the CFS as a quick and easy-to-use technology that reduces social and physical complexity into a clinical score. This stratifies older people by frailty score and permits the allocation of resources along these lines. We show how this is justified through epidemiological discourses of risk, which are merged with the language of individual mortality prediction. We discuss the proceduralisation of the CFS alongside a growing body of research that problematises its application in resource allocation. We argue that the pandemic has increased the use of the concept of frailty and that this effectively obfuscates the concept's limitations and ambiguities;the ageism implicit in the response to COVID-19 in the UK;and the relative resource scarcity facing the UK's NHS.
Public Health And Safety; Frailty; COVID-19; rationing; Resource allocation; Pandemics; Discourse analysis; Epidemiology; Health services; Discourses; Methodological problems; Technology; Older people; Critical theory; Electronic publishing; Internet resources; Medical decision making; Scarcity; Medicine; Clinical guidelines; Age discrimination; Critical care; Research applications; Coronaviruses; United Kingdom--UK
Full text:
Available
Collection:
Databases of international organizations
Database:
ProQuest Central
Type of study:
Prognostic study
/
Qualitative research
Language:
English
Journal:
Critical Public Health
Year:
2023
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS