In late February and early March 2020, Italy became the European epicenter of the Covid-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure and extraordinary efforts were made in order to increase overall hospital beds availability and especially ICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced a shortage of ICU beds and resources that led to hard allocating choices. At the beginning of March 2020, the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) issued recommendations aimed at supporting physicians in prioritizing patients when the number of critically ill patients overwhelm the capacity of ICUs. One motivating concern for the SIAARTI guidance was that, if no balanced and consistent allocation procedures were applied to prioritize patients, there would be a concrete risk for unfair choices, and that the prevalent “first come, first served” principle would lead to many avoidable deaths. Among the drivers of decision for admission to ICU, age, co-morbidities and preexisting functional status were included. The recommendations were criticized as ageist and potentially discriminatory against elderly patients. Looking forward to the next steps, the Italian experience can be relevant to other parts of the world that are yet to see a significant surge of COVID 19: the need for transparent triage criteria and commonly shared values, give the Italian recommendations even greater legitimacy.

Craxi Lucia, Vergano Marco, Savulescu Julian, Wilkinson Dominic (2020). Rationing in a Pandemic: Lessons from Italy. ASIAN BIOETHICS REVIEW, 12, 325-330 [10.1007/s41649-020-00127-1].

Rationing in a Pandemic: Lessons from Italy

Craxi Lucia
;
2020-01-01

Abstract

In late February and early March 2020, Italy became the European epicenter of the Covid-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure and extraordinary efforts were made in order to increase overall hospital beds availability and especially ICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced a shortage of ICU beds and resources that led to hard allocating choices. At the beginning of March 2020, the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) issued recommendations aimed at supporting physicians in prioritizing patients when the number of critically ill patients overwhelm the capacity of ICUs. One motivating concern for the SIAARTI guidance was that, if no balanced and consistent allocation procedures were applied to prioritize patients, there would be a concrete risk for unfair choices, and that the prevalent “first come, first served” principle would lead to many avoidable deaths. Among the drivers of decision for admission to ICU, age, co-morbidities and preexisting functional status were included. The recommendations were criticized as ageist and potentially discriminatory against elderly patients. Looking forward to the next steps, the Italian experience can be relevant to other parts of the world that are yet to see a significant surge of COVID 19: the need for transparent triage criteria and commonly shared values, give the Italian recommendations even greater legitimacy.
2020
Settore MED/02 - Storia Della Medicina
Settore MED/43 - Medicina Legale
Craxi Lucia, Vergano Marco, Savulescu Julian, Wilkinson Dominic (2020). Rationing in a Pandemic: Lessons from Italy. ASIAN BIOETHICS REVIEW, 12, 325-330 [10.1007/s41649-020-00127-1].
File in questo prodotto:
File Dimensione Formato  
Proof ABR.pdf

accesso aperto

Tipologia: Pre-print
Dimensione 230.63 kB
Formato Adobe PDF
230.63 kB Adobe PDF Visualizza/Apri
41649_2020_Article_127.pdf

Solo gestori archvio

Tipologia: Versione Editoriale
Dimensione 224.4 kB
Formato Adobe PDF
224.4 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/423355
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 29
  • ???jsp.display-item.citation.isi??? 105
social impact