Covid-19 patients with best chance of survival to be prioritised

Patients with the best chance of survival are to be prioritised as coronavirus overwhelms the health service, even where families disagree, the Medical Council has told doctors.

“In making decisions based on the principle of prioritising the use of scarce resources to treat those patients most likely to survive, more lives are likely to be preserved,” it has said.

This appraisal of the potential benefits a treatment might provide to different patient “lies within the scope of experienced intensive care medicine doctors,” the note for doctors on Covid-19 says.

However, “patients, families or allied may sometime hold different views”.

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According to the “important update” sent to doctors on Sunday, healthcare resources “may become overwhelmed” as the impact of the pandemic grows.

Allocation of “finite” healthcare resources in a way that is equitable and just “will present difficult choices”.

“Doctors have a duty to use resources prudently and fairly, to produce the most benefits possible for individuals served by those interventions.”

Intensive care

The council says it recognises the difficulties this will raise, particularly for those working in intensive care, who will have to evaluate patients and identify those with the best chance of recovery.

The council also says “any site” designated as a clinical site in the current emergency will be deemed appropriate for doctors to work in, provided it is under the supervision of the nearest hospital or a senior clinician.

It may necessary for doctors to perform duties “outside their current scope of practice” during the crisis but all tasks and roles carried out should be within their capabilities and with adequate supervision.

The council says doctors have a duty to protect their own health while giving compassionate care to patients.

“Please remember that amidst the increased workload, longer hours, additional pressure and stress, please take the time to care for yourself. Take breaks, eat regularly, and get rest.

“All doctors are on the front line, and the priority for doctors is to self-protect in order to protect and treat others. A sick doctor becomes a patient, while a healthy doctor can treat and see patients or remotely triage and help patients and our communities.

“Please remember that during this challenging time the Medical Council stands by your side. The entire country stands by your side.”

The Medical Council is the professional body for more than 20,000 doctors.