Conditions are dire in Italy. The resources and medical personnel needed are insufficient for the task. The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has told them to treat patients as if they were in a war zone: Treat those who are easy to save, and give palliative care to the rest.
This was preventable, but politicians kowtowed to China for money.
There are now simply too many patients for each one of them to receive adequate care.
Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow as these already extraordinary circumstances worsen.
“Informed by the principle of maximizing benefits for the largest number,” they suggest that “the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”
The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: “It may become necessary to establish an age limit for access to intensive care.”
Those who are too old to have a high likelihood of recovery, or who have too low a number of “life-years” left even if they should survive, would be left to die. This sounds cruel, but the alternative, the document argues, is no better. “In case of a total saturation of resources, maintaining the criterion of ‘first come, first served’ would amount to a decision to exclude late-arriving patients from access to intensive care.”
In addition to age, doctors and nurses are also advised to take a patient’s overall state of health into account: “The presence of comorbidities needs to be carefully evaluated.”
The doctors will be forgiven for choosing who lives and who dies. Those who put them in this situation should never be.