Denying the elderly access to intensive care units simply because of their age would be “discriminatory, ageist and morally wrong”, a coalition of UK charities for older people has warned.
Decisions over which coronavirus patients receive priority treatment, they say, cannot “be blanket ones, based on age alone or with a person’s age given undue weight as against other factors, such as their usual state of health and capacity to benefit from treatment”.
Governments across the world are developing ethical guidelines and decision tools to help their doctors to prioritise patients for hospital admission and treatment during the coronavirus pandemic.
The signatories of the open letter said that assessments should continue to be made on a case-by-case basis through honest discussion with the patient, their family and relevant professionals.
The open letter comes days after the National Institute for Health and Care Excellence (NICE) issued an “algorithm” to help doctors decide who should be admitted to critical care and who should not. It does not categorise potential patients by age but instead asks doctors to score patients on a nine-point “clinical frailty scale” [CFS].
The scale ranks patients from one [very fit] to nine [terminally ill] and divides patients at a score of five, [mildly frail].
Those with a score of less than five who would like critical care are considered well enough to benefit, subject to a review of any underlying conditions and the severity of their illness.
Those scoring over five are put through a process where doctors must decide if critical care is “considered appropriate” before proceeding.