Doctors may have to choose ‘which patients to prioritise’

A Department of Health ethical framework for operating during a pandemic makes clear doctors may have to make decisions on which patients should be prioritised for treatment.

Drawn up last March and updated in September, it says that under normal circumstances, all individuals have an equal claim to healthcare. However during a pandemic, healthcare resources, particularly critical care resources, are likely to become limited over time.

“Decisions should be principally based on the health-related benefits of allocation mechanisms. Thus, the starting point for any rationing decision is to consider which patients are most likely to benefit from the intervention.”

It says that “categorical exclusion, e.g. on the basis of age, should be avoided as this can imply that some groups are worth saving more than others and creates a perception of unfairness”.

“It is not appropriate to prioritise based on social status or other social value considerations, eg income, ethnicity, [or] gender. However, it may be ethical to prioritise certain at-risk groups and those essential to managing a pandemic for treatment.”