By Charlotte Webster-
Coronavirus patients with low survival chances could have their treatment withdrawn and offered to others who are more likely to survive, according to new guidance for doctors has warned.
The British Medical Association’s (BMA) latest ethics advice said health professionals could be forced to make “grave decisions” in the event hospitals become overwhelmed with patients.
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The document says that decisions around rationing scarce resources, such as ventilators, could determine whether large numbers of patients will receive life-saving treatment or not. It’s underlying rationale is to maximise the survival chances of those who need the treatment most given the limited shortage of ventilators at the moment. Patients with underlying issues who have a limited chance of survival will be withdrawn from ventilators in favour of those more likely to survive with the aid of maximum treatment.
The news comes as over 2,000 patients have died in hospital after testing positive for the virus as of 5pm on Tuesday, the Department of Health said, up by 563 from 1,789 the day before. The British government has promised to provide considerably more ventilators and provide a lot more testing for NHS staff than is currently happening.
Prime Minister Boris Johnson said in a video posted on Twitter that it was a “sad, sad day” and that his “thoughts go out to the families of the victims”. Defence Secretary Ben Wallace became the fourth Cabinet minister to self-isolate due to Covid-19.
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Dr John Chisholm, chairman of the BMA’s medical ethics committee, said: “Looking ahead to the coming weeks, if hard choices are required, we know they will be contested. There will be anger and pain.
“People who, in normal circumstances, would receive strenuous treatment may instead be given palliation in order to favour those with greater likelihood of benefiting.
“Nobody wants to make these decisions, but if resources are overwhelmed, these decisions must be made.” The BMA’s guidance states that during the peak of the pandemic doctors may have to assess a person’s eligibility for treatment based on a “capacity to benefit quickly” basis.
“Health professionals may be obliged to withdraw treatment from some patients to enable treatment of other patients with a higher survival probability,” the guidance states.
“This may involve withdrawing treatment from an individual who is stable or even improving but whose objective assessment indicates a worse prognosis than another patient who requires the same resource.”
Meanwhile, Professor Yvonne Doyle, medical director of Public Health England (PHE), said at a Downing Street press briefing that 10,000 coronavirus tests per day were now being carried out and the aim was to get to 25,000 tests by mid-April. She said the intention was to “get from thousands to hundreds of thousands” of tests for frontline workers in the coming weeks.
Image:Hamilton.medical.com
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