Along with the rapid increase in hospital admissions in our country, there is also that of "cases of patients with severe clinical pictures related to Covid-19 who refuse to be admitted to the ICU or to undergo life-support treatments deemed useful and appropriate by the carers ". To write it, in a document published on the portal, is the Italian Society of Anesthesia Analgesia Reanimation Intensive Therapy (Siaarti) which underlines: "however difficult and tiring the circumstances may be, the patient's repeated and obstinate refusal must not be followed by his 'abandonment' ".
In the text entitled "Pandemic and refusal of life support treatments", Siaarti refers to "some general elements regarding consent to treatment and the relative decision-making process", in precise reference to the Code of Medical Ethics, underlining that "no treatment health care can be imposed on anyone, even if the proposed diagnostic or therapeutic treatment is a 'life-saving' treatment ". Even where healthcare professionals find themselves dealing with 'deniers' or' no-vax ', a respectful and' non-judgmental 'attitude must never be lacking, even if this represents' a burdensome and painful aspect for doctors. and for nurses'. The tension to offer life chances,always oriented to carefully evaluate the proportionality of care, we read, "requires all of us to make an effort to explain and motivate in time, with the utmost attention and respect, in a clear, truthful and documented way", but also "with reasonable insistence "the usefulness of using life support treatments," including, if clinically appropriate, invasive ventilation ". "Although the circumstances may be difficult and tiring - it is specified - the repeated and obstinate refusal of the patient must not be followed by his 'abandonment'. Rather, he must always be guaranteed an adequate level of care and, if necessary, their remodeling in palliative key ". As such, concludes the scientific society, "all phases,the reasons and decisions relating to consent to diagnostic-therapeutic treatments, including life support ones, or to their refusal must be documented from time to time in the medical record ".
