Doctors face hard choice: Who lives, who dies?
NEW DELHI: Last month, a video went viral claiming doctors in Madrid were removing people aged over ..
NEW DELHI: Last month, a video went viral claiming doctors in Madrid were removing people aged over 65 from ventilators, to save lives of younger Covid-19 patients. It turned out to be fake news, but a situation in which doctors have to choose between patients is not unlikely now, as the number of Covid-19 cases continues to rise.
All over the world, hospitals are under tremendous strain. There arent enough ICU beds and ventilators to save every critical patient. On a routine day, who gets attention first depends on the severity of their condition. You have an accident victim with signs of internal bleeding, and another with a fractured arm: the haemorrhaging patient comes first.
The corona pandemic has made the ordinary rules of triage or patient classification meaningless. Now, there is a stream of critically ill patients. Say, you are a doctor with one remaining ventilator and three new arrivals. Whom do you save? Whom do you let die?
Its an ethical dilemma that no doctor wants thrust upon them. Thats why general rules to deal with such situations have existed for a long time. While military hospitals often need to make use of them, this is the first global medical crisis in a long time thats forced hospitals to dust their manuals, and medical ethicists to work on improving the existing guidance. They know that the allocation of equipment and care to patients will always be contentious, but they need to make it clear, ethical and equitable as far as possible.
Take the situation above: one hospital may decide to save the youngest of the three patients, arguing that they have had the least time to live, and an early death would be most unfair to them. This is a perfectly valid philosophical position, but another hospital might decide to save whoever has the best chance of survival. In Germany, for instance, triage does not take a patients age into consideration.
What if one of the patients is 19, another is 40 but in good health otherwise, and the most likely to survive, and the third is a nurse, whose recovery could help many other patients live. This time, many hospitals would choose to save the nurse for societys good.
Thats the main difference between triage in an emergency (accident victims) and a crisis (stream of Covid-19 cases). During an emergency, doctors aim to do Read More – Source
