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. 2022 Mar 13;23(1):24.
doi: 10.1186/s12910-022-00763-2.

What if some patients are more "important" than others? A possible framework for Covid-19 and other emergency care situations

Andrea Lavazza  1   2 , Mirko D Garasic  3
Affiliations

What if some patients are more "important" than others? A possible framework for Covid-19 and other emergency care situations

Andrea Lavazza et al. BMC Med Ethics. .

Abstract

Background: The Covid-19 pandemic caused situations where, in some hospitals, there were more patients in need of urgent treatment in intensive care units (ICU) than were available. In particular, there were not sufficient ventilators or critical care resources for all patients in danger of dying from respiratory failure or other organ failures.

Discussion: As the "first come, first served" criterion was not considered adequate, more nuanced and fairer clinical criteria were proposed to assess whom to treat first. One type of patients that has not been considered in the literature so far is that of "important patients", individuals that many people might consider worthy of priority treatment for the contribution they made or might make to society as a whole. In this article, we discuss the moral insights behind the possible treatment of "important patients" and suggest a supererogatory solution of voluntary renunciation/withdrawal. Details of the proposal are explained, and potential objections are addressed.

Keywords: Altruism; Healthcare renunciation; Informed consent; Priority treatment; Triage.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Mannelli C. Whose life to save? Scarce resources allocation in the COVID-19 outbreak. J Med Ethics. 2020;46(6):364–366. doi: 10.1136/medethics-2020-106227. - DOI - PubMed
    1. White D, Lo B. A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. JAMA. 2020;323(18):1773–1774. doi: 10.1001/jama.2020.5046. - DOI - PubMed
    1. Liddell K, Skopek JM, Palmer S, Martin S, Anderson J, Sagar A. Who gets the ventilator? Important legal rights in a pandemic. J Med Ethics. 2020;46:421–426. doi: 10.1136/medethics-2020-106332. - DOI - PubMed
    1. Iserson KV. Healthcare ethics during a pandemic. WestJEM. 2020;21(3):477–483. - PMC - PubMed
    1. McGuire AL, Aulisio MP, Davis FD, Erwin C, Harter TD, Jagsi R, Klitzman R, Macauley R, Racine E, Wolf SM, Wynia M, Wolpe PR. Ethical challenges arising in the COVID-19 pandemic: an overview from the association of bioethics program directors (ABPD) task force. AJOB. 2020;20(7):15–27. - PubMed