We’re told that the coronavirus will mean doctors have to make difficult decisions. Sure, it will, but there’s nothing new about such decisions, they’re of the type that doctors have been making for centuries, millennia. It’s called triage:
ICU doctors now face the toughest decisions they will ever have to make
It could be that they’ll have to make more of these decisions but there’s nothing remarkable at all about the underlying necessity:
The magnitude of the coronavirus pandemic will involve making decisions that, in normal times, doctors aren’t confronted with: decisions about which patients to treat in ICU when not all can be.
No, that’s not how it works. All medicine performs triage. The division into three groups. Those who will be fine without treatment, or at least can wait for as long as necessary for treatment to become available. Those who, whatever is done, are going to die real soon now – who we don’t treat other than to make them comfortable. The third group – and thus triage as a word – are those who will die, or be horribly maimed etc, without treatment now and who will also respond to treatment right now. Those are the ones who go to the front of the queue.
Any and every A&E department practices this all the time every day. Your shoulder sprain might take hour upon hour to be seen to. That bloke who just crushed his skull coming off the Norton on the bend gets a brief glance and a call for the priest of his assumed preference. That severed jugular still spurting – showing both a heart still pumping and the presence of blood to pump – gets treated right now.
All health care systems do this all the time.
We have further proof that the NHS – yea, even that Wonder of the World – does this. Recall that Liverpool Care Pathway? Those dying are simply sedated, sans food or even liquids, until they dehydrate into the grave? What do you think this is other than triage? These people are going to die in the next few days, couple of weeks. Make them comfortable as can be and don’t treat them. This is done every single day in every major hospital in the country.
Coronavirus may be changing the frequency with which these decisions must be taken but it’s not changing that basic need in the slightest.