Coronavirus patients may have life-saving treatment withdrawn if others with the virus are more likely to survive, according to new guidance issued to UK doctors.
Health workers could be forced to make “grave decisions” should hospitals become overwhelmed with COVID-19 patients, the latest advice from the British Medical Association (BMA) states.
The document warns that decisions around rationing scarce resources, such as ventilators, could determine whether large numbers of patients will receive life-saving treatment or not.
The deaths of another 563 coronavirus patients in the UK were announced on Wednesday, the country’s biggest daily increase since the outbreak began.
A total of 2,352 people with COVID-19 are now confirmed to have died in the UK.
Prime Minister Boris Johnson has admitted testing for the virus needs to “massively ramp up” after criticism of the government’s approach to it.
According to the new BMA guidance, doctors will face decisions “which mean some patients may be denied intensive forms of treatment that they would have received outside a pandemic”.
“Health professionals may be obliged to withdraw treatment from some patients to enable treatment of other patients with a higher survival probability,” the document states.
“This may involve withdrawing treatment from an individual who is stable or even improving but whose objective
assessment indicates a worse prognosis than another patient who requires the same resource.”
The BMA’s guidance says that during the peak of the pandemic doctors may have to assess a person’s eligibility for treatment based on a “capacity to benefit quickly” basis.
It also states that one of the “guiding principles” for doctors during a pandemic is that “everyone matters and everyone matters equally, but this does not mean that everyone will be treated the same”.
Dr John Chisholm, chairman of the BMA’s medical ethics committee, said: “Looking ahead to the coming weeks, if hard choices are required, we know they will be contested. There will be anger and pain.
“People who, in normal circumstances, would receive strenuous treatment may instead be given palliation in order to favour those with greater likelihood of benefiting.
“Nobody wants to make these decisions, but if resources are overwhelmed, these decisions must be made.”
It comes as the government faces intense scrutiny over its COVID-19 testing policy for both NHS workers and the wider public.
NHS staff have expressed frustration that they are being forced to self-isolate just as they are most needed, because tests are not available to show whether they are clear of the disease.
Analysis: Government rhetoric on testing ‘nowhere near matches the reality’
Downing Street has said more than 2,000 NHS staff have so far been tested for coronavirus. There are about half a million frontline NHS staff.
Professor Yvonne Doyle, medical director of Public Health England (PHE), told the Number 10 daily press briefing that 10,000 coronavirus tests per day were now being carried out and the aim was to get to 25,000 tests by mid-April.
She said the intention was to “get from thousands to hundreds of thousands” of tests for frontline workers in the coming weeks.
In a video posted on Twitter on Wednesday evening, Mr Johnson said it was a “sad, sad day” and admitted the UK needs to “massively ramp up” testing for coronavirus.
The PM – who is self-isolating after testing positive for COVID-19 – said: “It’s crucial people who do have the disease are able to be tested positive and to take the necessary steps to isolate at home in the way that I am doing and many many others are doing.”