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- Title
Ensuring nondiscrimination in pandemic prioritization decisions.
- Authors
Weiss, Matthew J.; Carnevale, Franco; Rochwerg, Bram; Oczkowski, Simon; Dhanani, Sonny
- Abstract
We read with great interest the I CMAJ i commentary by Parhar and colleagues[1] that described triage protocols in Alberta for extracorporeal life support (ECLS) resources. Although we acknowledge that it is reasonable in a pandemic situation to limit access to some intensive resources like ECLS for patients with conditions that limit their chance of survival, these decisions need to be based on predicted patient outcome as judged by the best available evidence, using the most objective criteria possible. The commentary did not specify which preexisting medical conditions would qualify for exclusion from ECLS.[1] Other Canadian reports have gone further to propose the explicit exclusion of patients with preexisting cognitive impairments.[2] We contend that comorbidities that do not influence expected probability to survive, notably preexisting cognitive or motor disability, should not be factored into triage decisions.
- Subjects
COGNITION disorders; COMORBIDITY; BIOETHICS; COVID-19; MEDICAL care
- Publication
Canadian Medical Association Journal (CMAJ), 2020, Vol 192, Issue 15, pE421
- Publication type
letter
- DOI
10.1503/cmaj.75254