Faced with the influx of Covid-19 patients in intensive care, and the question of the triage of patients, it would be necessary to be able to systematically advise unvaccinated adults to write advance directives to say whether or not they wish to be resuscitated, estimates in a tribune in the Sunday Journal Professor André Grimaldi, one of the figures in the defense of the public hospital.
"The question posed by the current 5th wave and the announced 6th wave is once again that of sorting out patients to be admitted to intensive care", writes this emeritus professor in diabetology from the Parisian hospital of Pitié-Salpétrière, recalling that "d Now, the activation of the white plans leads to postponing non-emergency operations and hospitalizations to give priority to Covid patients who need to be intubated and ventilated ”.
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“It is useful to remember that caregivers treat according to the needs of patients, without any other consideration, that is to say without involving their judgment on the political and religious convictions of their patients or on their beliefs or representations or on their health behaviors, farsighted or not, observant or not, ”he emphasizes.
"Which one to give priority to?
"
“Doctors take the Hippocratic Oath for this.
This does not mean that they do not have a moral judgment, but that this judgment must not intervene in their relationship with the patient and influence their decisions, ”he recalls.
"But this ethical reminder does not erase the question of sorting when there is only one bed for two patients both under intensive care".
"Which one to prioritize?
It is up to caregivers to decide collegially, but it should be up to learned societies, independent agencies, ethics committees and, beyond, society as a whole and its elected officials to debate the principles which should guide them. caregivers ”, continues the doctor.
This is why in his eyes, "it would be good to systematically advise any adult person refusing to be vaccinated to write advance directives to say whether or not they wish to be resuscitated in the event of a severe form of Covid".
"Shouldn't a person claiming the free choice not to be vaccinated consistently assume their free choice not to be resuscitated?"
“Asks the practitioner.
A column signed by about fifteen doctors and published at the end of December in the newspaper Le Monde already raised the question of taking into account the vaccination status in the prioritization of Covid patients in intensive care.