Comprehensive national guidelines ‘essential to ensuring public trust and confidence’, says Nuffield Council on Bioethics
The Nuffield Council on Bioethics has called for “authoritative and comprehensive national guidelines” on resource allocation decisions during the Covid-19 pandemic.
The bioethics council said that pressures in March and April last year meant there were “a number of concerns that the NHS might find itself overwhelmed, and that demand for intensive care unit beds, mechanical ventilation and other critical care interventions would outstrip supply”.
In such circumstances, “agonising decisions” about which patients should be prioritised for certain care and treatment have to be made, said council chair Dave Archard and director Hugh Whittall.
For example, they said, in the event that demand outstrips supply, how should clinical teams proceed and who should they prioritise? They also noted that the longer the crisis continued, the less justifiable it would become to ignore health needs unrelated to Covid-19.
“These are not just matters of intellectual curiosity but are the questions needing answered on the front line,” Archard and Whittall said.
Their call comes as UK hospitals face the highest-ever waiting lists, and the number of people who died from Covid-19 in the country is more than 100,000 according to some statistics.
“Record increases in daily Covid-19 cases combined with routine winter pressures in the NHS threaten to overwhelm and engulf,” they added. “These decisions are no longer a worst-case scenario but an immediate reality.”
While a number of professional organisations have provided advice about how such decisions should be approached, this “does not meet the need for authoritative and comprehensive national guidelines”, the council heads said.
The organisation is calling on the government to urgently issue nationally developed and coordinated guidance on decisions about the allocation of limited resources.
Moreover, they said, the government must ensure that this guidance is “developed at pace, whilst endeavouring to hear a broad range of perspectives and voices”.
In addition, the government should “communicate clearly the advice being given to healthcare professionals and members of the public, setting out the ethical considerations that have informed decisions and why”.
“Doing so is essential to ensuring public trust and confidence,” they said.