Thursday, November 30, 2023

Bioethical guide amended to remove age as factor in life-death decisions

The federal government’s General Health Council (CSG) has updated its bioethical guide, removing age as a factor when doctors are forced to make decisions about which patients should take priority when medical resources are limited.

The Bioethical Guide to Allocation of Critical Medicine Resources had argued that the lives of younger people should be prioritized over those of older people should the health system become overwhelmed during the coronavirus crisis.

However, it now states that the only factor that should be considered when allocating limited resources such as ventilators is a patient’s chance of survival.

“Patients with a greater probability of survival with the assistance of critical medicine are prioritized over those with a lesser probability,” the guide says.

If two or more patients are deemed to have the same chance of survival, medical personnel in the first instance should take into account that the Covid-19 fatality rate is not the same between the sexes.

Male coronavirus patients have died at a much higher rate than females, meaning that the bioethical guide recommends treatment of the latter be prioritized when there is no other way to distinguish between chances of survival.

If doctors are trying to decide who should be prioritized when the patients being considered are of the same sex, first priority should go to “people who belong to vulnerable groups,” the guide says. “As a last resort,” decisions about who should be prioritized for treatment should be taken “randomly and transparently.”

The CSG guide also says that patients must be made aware of their diagnosis and prognosis as well as any limitations faced by the hospital where they are being treated with respect to the availability of medical resources.

In addition, “patients must have the opportunity to make their wishes known about the treatments and interventions they want,” the guide says.

Patients must have the opportunity to make medical personnel aware of any advance healthcare directive, or living will, they might have. An advance healthcare directive is a legal document in which a person specifies what actions should be taken for their care if they are no longer able to make decisions for themselves due to illness or incapacity.

“The wish not to be subjected to a certain treatment must always be respected,” the guide says. “For example, any instruction ‘not to intubate’ or ‘not to resuscitate’ must be recorded in [the patient’s] clinical file and be respected.”

Source: El Universal (sp) 

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