It is an extraordinary document published by the Italian society for anesthesia, resuscitation and intensive care medicine (SIAARTI). As a reaction to the Covid-19-state of emergency in Italy, the document contains "recommendations for clinical ethics and for admission to intensive treatment or your exposure under the extraordinary conditions of imbalance between need and available resources". The easier it is formulated to a manner that is ethically very difficult question: Who is treated and who is not?
The document illustrates the dramatic extent that has reached the Coronavirus crisis in Italy. More and more hospitals to reach the limit of their capacity. The doctor and nursing staff is at the Limit, there is a lack of increasing beds and medical equipment. All of this means that not all patients receive the best possible treatment. It is a scenario with the disaster medicine comparable to. "In view of the severe shortage of medical resources, the allocation criteria must ensure that the patients with the highest chances of therapeutic success of medicine will have access to intensive," it says in the SIAARTI document. "It's about "the highest hope of life and Survival" in the foreground."
patient Triage, as in the war
The document includes a series of recommendations. For example, it could be necessary", an age limit for access to the intensive care set". This is not a value judgment, but a possibility of extremely scarce resources for those who have the highest probability of Survival and the largest number of saved years of life could enjoy. "The principle of utility maximization applies to the largest number of people." Another recommendation is: "in addition to the age this must also be the presence of concomitant diseases carefully evaluated. It is conceivable that a may be relatively short treatment duration could be in healthier people, longer and more resource-intensive, if it is older or more sensitive patients."
What this could mean in practice, said Christian Salaroli, an anesthesiologist at the hospital John XXIII. in Bergamo, in an interview with the newspaper "Corriere della Sera". "As in war situations, we decide according to the age and the General state of health over the therapy of a patient," said Salaroli. In the case of a Covid-19-patients between the ages of 80 and 95 with heavy lung "would fail most likely not a Rescue action taken".
"It is not true that we let patients die."Robert Fumagalli, hospital Niguarda, Milan
medical-ethical guidelines in Switzerland
due To the speed with which the Coronavirus widely used, could also arise in Switzerland, medical shortages in intensive care units. In the event that a Triage in critically ill patients is necessary, there is as a guide for the medical Profession, medical-ethical guidelines of the Swiss Academy of Medical Sciences (SAMS).
At a Triage must be explained to the criteria used in a factual and transparent. Apply the criteria in a fair process without discrimination, such as age, gender, Canton of Residence, insurance status, nationality or religious affiliation. If intensive medical treatment is not enough for all, "those patients with the highest priority whose prognosis with intensive treatment, without these, but inconvenient", as SAMS writes.
property location in Italy helps to understand "what's before us,"
the document of the Italian society for anesthesia, resuscitation and intensive care medicine, circulating now in the social media. The well-known political scientist Yascha Mounk, a Professor at the Johns Hopkins University, picked up on it. He translated extracts from the Italian into English, "to help the people of Germany to America, to understand what is in store for us" – if it is possible to prevent in these countries, an exponential increase of the infection. The goal must be to put the brakes on the spread of the Virus, in order to protect the health system against Overload.
The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care just published the most extraordinary medical document I've ever seen.— Yascha Mounk (@Yascha_Mounk) March 11, 2020
To help people from Germany to America understand what we’re about to face, I am publishing translated extracts here.
in Total were infected, according to the official statistics, in Italy more than 12’460 people with the Coronavirus, so far, 827 people have died. Experts anticipate a high number of unrecognised cases. To contain the Corona of a pandemic, Italy has tightened its blocking measures again considerably. Since this Morning most of the shops around the country remain closed. There are only a few exceptions, grocery stores, pharmacies, and the tank allowed to stand, and some of the other shops continue to open. Bars and Restaurants all need to go very close.
Created: 12.03.2020, 21:44 UhrUpdated Date: 12 March 2020, 21:04