Sunday, November 29, 2020

How COVID-19 Is Forcing Doctors to Compromise Their Oath to Heal

The sobering comment by Former Health Minister Duane Sands has set off a public debate mixed with fury and uncertainty.

Sands on a local radio station, Guardian Radio, “The Hitback,” with Nahaja Black, said the heightened case of coronavirus in the country has placed doctors in a position to decide who lives and who dies.

The earnest reality of the pandemic has caused doctors to place patients with other life-threatening diseases like heart disease and cancer on the back burner, causing some to die.

With a high degree of certainty, the former minister said, “I understand the implications of my comment…that is happening now.”

Other countries have done the same

Physicians in the United States of America, Canada, and Italy have already been forced to make such moral decisions.

These countries have larger populations and the unexpected wave of the virus has filled their hospitals beyond capacity. Back in early March, Italy’s health system said there were too many patients for each one to receive adequate care. So, the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)  published guidelines that doctors should follow as cases worsen.

These patients should be left to die as they place demands on scarce medical resources, according to the document written by a group of medical doctors.

  • Patients that are old
  • Patients with comorbidities
  • Patients who require intensive care

They are guided by the utilitarian approach which stresses the principle, “the greatest good for the largest number,” which would ensure that patients with the highest chance of survival will access intensive care.

Doctors in the Bahamas are reaching that point

When health facilities are full to capacity, physicians are placed in a position where they are unable to manage and provide care for a patient who may need respiratory assistance.

Dr. Nikkiah Forbes, director of the Infectious Disease Programme said she has not personally seen a patient die because of the ability to provide care, but the country is close.

“If we continue beyond capacity, those difficult decisions may have to be made,” she said.

Health workers confirmed that the Bahamas is in a surge and the system is being pushed beyond capacity, emphasizing that the ability to provide care in that environment is challenging.

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