How to decide who is assigned the last available bed in the ICU

If the number of COVID-19 patients in Swiss intensive care units (ICUs) increases dramatically, doctors will soon have to decide who will survive and who will not. Many older people are making the decision for themselves: they prefer not to go to hospital and die in nursing homes.

This content was published on 02 Nov 2020 – 11:54 AM

02 November 2020 – 11:54 am

“Nobody wants to be in a position to make such a decision,” Tanja Krones, head of clinical ethics at Zurich University Hospital, said on Sunday. Sunday newspaper. “Who gets vital care – and who doesn’t.”

Last week, Andrea Stettbacher, government representative for the coordinated medical service, warned that if no action is taken, ICU beds in Switzerland will be sold out within fifteen days.

The Swiss Academy of Medical Sciences has formulated guidelines on the triage system: people over the age of 85 should, for example, only receive palliative care. These guidelines are expected to be reviewed this week.

However, the elderly themselves generally do not want to be admitted to intensive care units, especially those living in nursing homes, according to the Sunday newspaper.

“Most of them still remember pictures of Italy with crowded rooms. And this is logically a deterrent, “says Alois Haller, head physician of the intensive care unit at the Cantonal Hospital in Winterthur.

Tanja Krones warns of the risk of advice given – or decisions made – outside the hospital of not hospitalizing patients, among other reasons, to protect the system. “Now that hospitals are full in some regions, we need to work together to ensure that this doesn’t happen. silent triage“, nut.