T&T, minefield doctors may have to choose who lives or dies....
With Intensive Care Unit spaces in the parallel healthcare system now almost gone, doctors are now closer to being placed in a position where they will have to choose who gets the critical, life-saving COVID-19 treatment. Despite having to shoulder this responsibility, the T&T Medical Association (T&TMA) and internal medicine specialist Dr Joel Teelucksingh do not believe there needs to be a formalised triage policy to determine who, quite literally, gets to live or die.
According to the T&TMA PRO Dr Keegan Bhaggan, such a policy will do more harm than good if it’s ever implemented.
“When you create a policy like that, policies are fixed documents based on the understanding at a given point in time and then that type of document removes the ability to practice the clinical skill or practice the clinical acumen on a case by case basis,” Bhaggan said yesterday.
Both men were addressing the prospect of medical practitioners getting to a stage where they may have to choose which patients get critical treatment due to the lack of ICU beds within the parallel healthcare system.
Bhaggan said such policy will not allow medical practitioners to keep up with the “dynamic changes” of COVID-19.
“Whether it’s the disease pattern, or whether it’s the resources we have available, or whether it’s the new ways of approaching treatment,” he said.
Much like Dr Bhaggan, Dr Teelucksingh said such a decision is best left in the hands of the specialist doctors treating directly with the patients. He noted that the oversubscribed ICU is not unique to T&T.
Doctors fear ‘ethical minefield’ of deciding who lives, dies from COVID
Trini Comments:
Claude Gonzales
Looks like THE PNM done lost control of EVERYTHING -- except keeping their BANDITS busy on the STREETS.
AGE DISCRIMINATION IS PURE POISON!!!
Scarlet Ibis
The problem here, as other countries, is that we've run our health system like an airline. As airlines don't like empty seats so hospitals don't like empty beds. Always at the brink, not developing extra capacity because shame if beds and equipment aren't used. Sad. We must increase capacity to at least 140 ICU-CCB in the parallel healthcare system to deal separately with this virus. We should have 140 ICU-CCB beds in normal circumstances. That's 10 ICU-CCB per 100,000 inhabitants in this land of 1,400,000 people. We must increase capacity. Get doctors and nurses from outside if we have to. Triage is difficult. What mustn't happen is care provided based on economic status, status in society or connections(the who knows who). Which as why I believe some general guidelines should be drawn up and sadly a panel set up. This is Trinbago. It's harsh, but the aim is to save life and therefore first you must try to save those who would have more life ahead of them. That means you would have to try to save younger people. It would favour younger people who may've more strength to fight. Likelihood of death is taken into account. Older people are more likely to die. Some refuse care due to religion. Lastly, those who took the medical advice to try to save themselves by taking the vaccine should receive preference over those who didn't. Silent enim leges inter arma. "For laws are silent when arms are raised." Cicero: Pro Milone. Popularly, "In times of war, the law falls silent."
The Resistance
I understand this predicament. These triage decisions can weigh heavy on a moral mind.
Harry Ramharack
In pre-covid times the importation of certain drugs by the MOH was delayed, disrupted and sometimes discontinued. Was that ethical?
Is it ethical for a doctor to prolong the suffering of a patient?
I Mulligan
Where are the crowded hospitals?? What does it look like inside?? See we got people LIVING at the hospitals because their families refused to retrieve them..it is a mess. The decision on who lives and who dies have been going on for decades on the Island. When you visit the hospital or health center you are treated like a burden. A couple years ago, a man complained of chest pains at the St. Helena Health Center, he was told to SIT and WAIT. The poor man died while waiting. No one noticed he was dead until after his name was called and he did not respond. When an ambulance was called, it took over an hour to arrive. See, these leaders in administrative position have no medical code of ethics in saving your life. All this sympathy about overworked nurses is an exaggeration because the workers, especially the health workers, are not skillfully trained and many have poor work ethics, they show up for a paycheck. Meanwhile, the doctors are getting younger and greedier for more money than showing a commitment to saving lives. How many negligence cases have piled up against the health care system?? Probably thousands in the few years. Sadly, many poor people who received horrible care are penniless to sue. They are the quiet ones. Even when a family member dies over minor illness where blatant negligence is present, they are silent.
Covid has not impacted the hospitals like in other countries. Show photos of packed ER and ICU...it looks like a shanty town inside...
Hector Carrington
I Mulligan, it's a sad and very disturbing commentary when or medical people are sometimes forced to effectively play God in determining which patient might live or who's effectively "condemned" to death. Even in mature facilities, such as ours, during the worst of COVID that difficult and vexing decision was required, but thankfully, not now. Let me take this opportunity to encourage those eligible for COVID-related vaccines to get vaccinated speedily and those eligible for a booster ought not to miss or postpone the opportunity. For the records, I got my 2 doses of Moderna in January and February and the just approved booster, the 3rd dose, last Friday. I'm convinced it's our best hope.
Raven Madoxx
Devils advocate:
You have been eating high sugar foods for 60 years...
You over weight, veins damaged and kidneys on the brink...
Covid is your death sentence.... Valhalla...!!
Civilian: You and Rowley real fool the country with this #1 in the world story ... but men like ME and PETER BAILEY and DEO -- YOU AND ROWLEY CYAR FOOL WE.
Ah have ah PETER BAILEY TABANCA in this hour of CRISIS. Please MR GUARDIAN MONITOR -- please forgive PETER BAILEY for his blunt style and let him continue his commentary. THE NATION is in CRISIS under this ROWLEY GOVERNMENT and we need all commentators on deck to bring sense to these PNM DESTROYERS OF THE NATION.
Especially bloggers like JOHNATAN JARDIN and FACT CHECK and the SAMUEL FELLAH and DEM!!!
