Withdrawal of intensive care during times of severe scarcity: Triage during a pandemic only upon arrival or with the inclusion of patients who are already under treatment?
Bioethics
; 35(2): 118-124, 2021 02.
Artículo
en Inglés
| MEDLINE | ID: covidwho-966421
ABSTRACT
Many countries have adopted new triage recommendations for use in the event that intensive care beds become scarce during the COVID-19 pandemic. In addition to establishing the exact criteria regarding whether treatment for a newly arriving patient shows a sufficient likelihood of success, it is also necessary to ask whether patients already undergoing treatment whose prospects are low should be moved into palliative care if new patients with better prospects arrive. This question has led to divergent ethical guidelines. This paper explores the distinction between withholding and withdrawing medical treatment during times of scarcity. As a first central point, the paper argues that a revival of the ethical distinction between doing and allowing would have a revisionary impact on cases of voluntary treatment withdrawal. A second systematic focus lies in the concern that withdrawal due to scarcity might be considered a physical transgression and therefore more problematic than not treating someone in the first place. In light of the persistent disagreement, especially concerning the second issue, the paper concludes with two pragmatic proposals for how to handle the ethical uncertainty (1) triage protocols should explicitly require that intensive care attempts are designed as time-limited trials based on specified treatment goals, and this intent should be documented very clearly at the beginning of each treatment; and (2) lower survival prospects can be accepted for treatments that have already begun, compared with the respective triage rules for the initial access of patients to intensive care.
Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Asignación de Recursos para la Atención de Salud
/
Cuidados Críticos
/
Privación de Tratamiento
/
Discusiones Bioéticas
/
COVID-19
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
/
Revisión sistemática/Meta análisis
Límite:
Humanos
País/Región como asunto:
Europa
Idioma:
Inglés
Revista:
Bioethics
Asunto de la revista:
Etica
Año:
2021
Tipo del documento:
Artículo
País de afiliación:
Bioe.12837
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