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Human rights and COVID-19 triage: a comment on the Bath protocol

In their discussion paper of November 2020, Cook et al present a draft protocol for navigating circumstances in which emergency services are overwhelmed. Their paper suggests that COVID-related triage decisions should be based on clinical assessment, patient and family consultation, and a range of e...

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Autores principales: Bhatt, Vivek, Michalowski, Sabine, Wyllie, Aaron, Kuylen, Margot, Martin, Wayne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054825/
https://www.ncbi.nlm.nih.gov/pubmed/33863831
http://dx.doi.org/10.1136/medethics-2021-107361
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author Bhatt, Vivek
Michalowski, Sabine
Wyllie, Aaron
Kuylen, Margot
Martin, Wayne
author_facet Bhatt, Vivek
Michalowski, Sabine
Wyllie, Aaron
Kuylen, Margot
Martin, Wayne
author_sort Bhatt, Vivek
collection PubMed
description In their discussion paper of November 2020, Cook et al present a draft protocol for navigating circumstances in which emergency services are overwhelmed. Their paper suggests that COVID-related triage decisions should be based on clinical assessment, patient and family consultation, and a range of ethical considerations. In this response, we note that the protocol exhibits an ambiguity that is likely to result in irresolvable dilemmas when put into practice. This ambiguity is exemplified in the paper’s prime ethical imperative (to ‘save more lives and more years of life’), which takes the form of an undefined conjunction whose practical implications are left unspecified. We see this ambiguity in the prime imperative as one manifestation of a broader set of tensions in the protocol. We show that the discipline of human rights provides an essential supplement to the ethical framework on which Cook and colleagues rely, providing a framework for understanding and working through triage dilemmas involving age, discrimination and equality.
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spelling pubmed-80548252021-04-20 Human rights and COVID-19 triage: a comment on the Bath protocol Bhatt, Vivek Michalowski, Sabine Wyllie, Aaron Kuylen, Margot Martin, Wayne J Med Ethics Response In their discussion paper of November 2020, Cook et al present a draft protocol for navigating circumstances in which emergency services are overwhelmed. Their paper suggests that COVID-related triage decisions should be based on clinical assessment, patient and family consultation, and a range of ethical considerations. In this response, we note that the protocol exhibits an ambiguity that is likely to result in irresolvable dilemmas when put into practice. This ambiguity is exemplified in the paper’s prime ethical imperative (to ‘save more lives and more years of life’), which takes the form of an undefined conjunction whose practical implications are left unspecified. We see this ambiguity in the prime imperative as one manifestation of a broader set of tensions in the protocol. We show that the discipline of human rights provides an essential supplement to the ethical framework on which Cook and colleagues rely, providing a framework for understanding and working through triage dilemmas involving age, discrimination and equality. BMJ Publishing Group 2021-04 2021-04-16 /pmc/articles/PMC8054825/ /pubmed/33863831 http://dx.doi.org/10.1136/medethics-2021-107361 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Response
Bhatt, Vivek
Michalowski, Sabine
Wyllie, Aaron
Kuylen, Margot
Martin, Wayne
Human rights and COVID-19 triage: a comment on the Bath protocol
title Human rights and COVID-19 triage: a comment on the Bath protocol
title_full Human rights and COVID-19 triage: a comment on the Bath protocol
title_fullStr Human rights and COVID-19 triage: a comment on the Bath protocol
title_full_unstemmed Human rights and COVID-19 triage: a comment on the Bath protocol
title_short Human rights and COVID-19 triage: a comment on the Bath protocol
title_sort human rights and covid-19 triage: a comment on the bath protocol
topic Response
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054825/
https://www.ncbi.nlm.nih.gov/pubmed/33863831
http://dx.doi.org/10.1136/medethics-2021-107361
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