Ethicists, doctors and triage decisions: who should decide? And on what basis?

Silvia Camporesi; Maurizio Mori

doi:10.1136/medethics-2020-106499

Ethicists, doctors and triage decisions: who should decide? And on what basis?

Silvia Camporesi, Maurizio Mori

University of Turin

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

Abstract

We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence that healthcare professionals would rather not be left alone with their ‘clinical judgments’ to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population.

Original language	English
Article number	106499
Journal	Journal of Medical Ethics
DOIs	https://doi.org/10.1136/medethics-2020-106499
Publication status	Published - 10 Jul 2020

Keywords

ethics committees/consultation
history of health ethics/bioethics
policy guidelines/inst. review boards
research ethics
resource allocation

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10.1136/medethics-2020-106499

Cite this

@article{1a35db3a4af54ae9ae8fe900f6a10b21,

title = "Ethicists, doctors and triage decisions: who should decide? And on what basis?",

abstract = "We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence that healthcare professionals would rather not be left alone with their {\textquoteleft}clinical judgments{\textquoteright} to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population.",

keywords = "ethics committees/consultation, history of health ethics/bioethics, policy guidelines/inst. review boards, research ethics, resource allocation",

author = "Silvia Camporesi and Maurizio Mori",

year = "2020",

month = jul,

day = "10",

doi = "10.1136/medethics-2020-106499",

language = "English",

journal = "Journal of Medical Ethics",