Pressure on Covid care may again lead to ethical choices
Spanish health care professionals have asked the government for immunity from their legal and criminal liability when forced to make critical choices regarding Covid care in the face of a ventilator shortage in the intensive care unit.
During the peak of the first wave of corona, choices had to be made in the intensive care units of Spanish hospitals. This was due to allocation of scarce ventilation equipment to critically ill patients. Choices were made after careful consultation However, IC staff were subsequently sued by relatives of deceased Covid patients.
Pressure on ICs in Spanish hospitals is rising once more. This brings the real possibility of being faced with difficult choices. Healthcare professionals demand legal protection against potential new charges. In April last year, a motion was submitted to the Senate. The motion requested it specify the principles and values for the implementation of Covid care in hospitals. The motion was passed by the Health Committee in November. So far, this has not resulted in any changes to current regulations.
A change in law has been requested by the authorities of the US state of Maryland. They laid down by law that charges against healthcare professionals would not be heard if they are the result of a shortage of ventilation equipment. “A health care professional is exempt from legal and criminal liability if he or she has acted in good faith in a catastrophic health care emergency,” the law reads.
“Ethically difficult decisions”
The call for legal protection in Spain does not only come from care professionals. Various organisations and teachers also underline the importance of criminal immunity in this exceptional situation. For example, the Spanish Association of Geriatrics and Gerontology (SEGG) and the Spanish Association of Internal Medicine (SEMI) have prepared a document with general recommendations when it comes to “ethically difficult decisions”. According to Senator Geroa Bai, support health workers receive from the government can help prevent emotional overload.
Spaniards give priority to the youngest patient
In a recent survey by the Spanish Centre for Sociological Research CIS, the question was raised whether, in case of scarcity, medical equipment should be removed from patients with the lowest life expectancy. Respondents could hypothetically prioritise the youngest patient, the sickest patient, or the oldest patient. The majority of respondents (29.6%) indicated that the equipment should be allocated to the youngest patient. 26.2% thought that the sickest patient should be entitled to the equipment first and 20.2% had no opinion about it.