Withdrawing critical care from patients in a triage situation

Med Health Care Philos. 2021 Jun;24(2):205-211. doi: 10.1007/s11019-020-09999-4. Epub 2021 Jan 4.

Abstract

The advent of COVID-19 has been the occasion for a renewed interest in the principles governing triage when the number of critically ill patients exceeds the healthcare infrastructure's capacity in a given location. Some scholars advocate that it would be morally acceptable in a crisis to withdraw resources like life support and ICU beds from one patient in favor of another, if, in the judgment of medical personnel, the other patient has a significantly better prognosis. The paper examines the arguments for and against this approach from the point of view of natural law theory, especially using the principle of double effect. We conclude that it is inadmissible to withdraw life-saving medical interventions from patients who are still benefiting from them, on the sole grounds that other patients might benefit more. Those who are currently using such technology should only interrupt their treatment if, in the judgment of medical personnel and, if possible, taking into account the wishes and needs of the patient and his family, the treatment is deemed futile, burdensome, or disproportionate.

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / therapy*
  • Critical Care* / ethics
  • Humans
  • Judgment
  • Triage* / ethics
  • Triage* / methods
  • Withholding Treatment* / ethics