Health An ethical protocol for the distribution of ICU-beds and,...

An ethical protocol for the distribution of ICU-beds and, in the case of a deficient harvest, critical


Michael Cooper, intensivist at the hospital in Leeuwarden, the netherlands, will soon be sixty. “Then I’ll fall fast for the cohort patients who are sixty to eighty years, which, according to ethics experts in the shortage of beds for less has the right to be intensivecareplek. However, I am a health care professional, so if I make a bad link, you’re from corona, and I do have more rights than the other patients.” Being treated in recent months to dozens of coronapatiënten in his SYSTEM.

On Wednesday, the protocol is not medical grounds on which doctors will, in the future, have to choose which patients get priority during a pandemic, and a shortage of ICU beds is created. The main reason for the record of the KNMG, the association of Medical consultants, and some of the professors of ethics and philosophy, it was the slight panic at the beginning of april, when over 1,400 coronapatiënten in the intensive care unit levels. Ordinarily, the Netherlands, at the most, 1.150 ICU beds in the room. It would be nearly everyone to make way for the coronapatiënten, which, on average, also be a two-to-four weeks. A normal ICU patient, there is a couple of days.

The new protocol is only in force when there were many more patients with the same level of chance of survival, then the spare room.

The doctors are happy that they are finally on an ethical footing, but the president of the Federation, Peter-Paul van Benthem. “We’re going to have to discuss it. And the ethicists will have choices in front of us that we would not make it. We are looking purely for a medical visit with a patient.” In addition, he said, the doctor’s today, and ideally with the patient on treatment. They weigh all of the pros and cons together. Van Benthem: “the fact That, together, will decide to disappear, when patients have to choose from due to a lack of beds.”

If the family of the patient, or the inspection afterwards to ask them why the port was rejected, the physician may indicate to the protocol. Van Benthem: “It’s not the end of it is different.”

You can also read: Protocol: specify the health care providers, and young people are a priority when there is extreme pressure on the IC

Criticism of the government and the Chamber

The government has already criticized the age criterion in the protocol. In a letter to parliament wrote to the minister responsible for the Medical Care of Martin van Rijn on Tuesday that he “can’t support”. “This government is that every life is equal, and as an elderly patient on medical grounds the same recovery chances has got to be one of the younger the patient, he or she may not be entitled to life-saving care will be denied to all.”

ICU doctors have asked politicians at the coronacrisis just for “support” in the selection process. However, according to a spokesman Of the river Rhine, it is only logical that the government will now be in the discussion mix. “This is not just about medicine, it is also a political one.”

The less time the patient is expected to be in the icu bed is occupied (with a coronapatiënt, there is a lot more than a person who has just been operated on), the earlier it will be selected. “Short of expected recording time has to be justified if the goal is to get as much as possible to save lives,” according to the protocol. People who are vulnerable, in the care, Covid-patients, will have to take precedence over the others. The 60-minners to go in excess of 60 years and older, based on the idea that they are more likely to miss out on a new life as they are dying. When two of the patients, after checking all the search criteria are the same, there needs to be a tie.

Lifestyle, age, social status, and family situation, counting it again, not with you. A bachelor of fifty and thirty years of smoking, so it has more of a right to an ICU bed with a married man of 65 years of age who has never smoked.

The government wants to make to the discussions, the KNMG and the FMS will be with their supporters to wait and see if it’s the script, in practice, it is workable. The two organisations say that the doctor “of course” be open to changes as society and politics is like that.

In the Second Room, to put before all of the pressure on the cabinet by the wall-to-wall with a vote, thank you a mobile crane and the SP to which the call is to the company’s “no age limits to use”. A mobile crane has found that the age criterion in the protocol is “to contribute to the feeling that you are at a certain age, is written off”.

As for the age criterion in protocol and continues to allow the government, with regulations for it to be removed, said the spokesman Of the Rhine river.

Always an individual consideration

Physicians, view always, or for a medical treatment makes sense for that particular patient. Gives him more health than the damage? A stay in the intensive care unit, is a last resort, and it is very stressful for the patient, for each day in the ICU, a week in rehab. The 80-year olds, who are sometimes already suffering from heart disease, high blood pressure, or diabetes, are rarely included in an intensive care unit. But some, including a sprinkling or two of his far more energetic than any other zestigers, so it should always be an the individual consideration it.

Intensivist Michael Cooper in perspective: “There will never be two subjects at a time that is just as strong. I’d like to lottery tickets. I think that for anyone out of turn”. According to Cooper, you’ll always have to have a medical assessment to take a picture. “It is also a constantly changing and often it will be the 80-year olds do not even have to go to the hospital to send.”

The difference between the start and the zestigers with the solar corona has been a medical point of view, not so great. Cooper: “a small group of young people who are in the hospital end up with serious solar corona) is very ill or in a vulnerable position.”

What to do can be done, ” says Cooper, “is that you have someone to pick up, and a moment later, a stronger, more patient, is, from, who, you think, ‘Damn, I also want to pick up, and now it is full. But then, do you create the space for you. That is what we have now, too. We have had them, and even to the German text below will be sent.”

As expected, ligduur one of the criteria, it will coronapatiënten in the future, you lose the game . Cooper: “And you, you always had to before the trauma (accidents, ed.). or the operations of choosing, because these patients continue to be reduced. That is not the case. Coronapatiënten went for it.”



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