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The ethics of PPE

If health care resources and staff are stretched to the limit, difficult life or death choices must be made.  Who to treat? That will be the question.

At ordinary times decisions might be made based on whether treatment will do more harm than good.  It might even be the patient who decides.  End of life decisions are more often like that.  Will further treatment help?



But these are not regular times.

The British Medical Association guidance on pandemics says

"In dangerous pandemics the ethical balance of all doctors and health care workers must shift towards the utilitarian objective of equitable concern for all – while maintaining respect for all as ‘ends in themselves’."

If resources are spent on saving the life of one person at the expense of many others, how then is that balance to be made?

One thing is sure.  Our actions are also part of this ethical mix.  Our efforts will determine whether or not the anticipated surge in those requiring treatment overwhelms the limited resources of the NHS.

A great deal is said about 'flattening the curve'.  But this is really what this is about.  It is about enabling our doctors and nurses to cope.  The more we can contain the numbers of cases at any one time, the easier the ethical decisions can be made or avoided.   Who lives and who dies depends on us as much as it does the medical staff.

But the government must also take responsibility too.  The lack of PPE is also making ethical decisions more difficult.   Medical staff should not be in their position of balancing the risk to their own lives against those of their patients.

Personal Protective Equipment is a resource that saves lives.   It does so in more ways than protecting health care workers and patients from infection.   It eases the availability of staff and that, in turn, helps save lives.

The real precious resource


The Health Secretary Matt Hancock said PPE was a 'precious resource.'

The Royal College of Nursing's General Secretary, Dame Donna Kinnair, responded on BBC Radio 4 that no PPE was "more precious a resource than a healthcare worker’s life, a nurse’s life, a doctor’s life".

The government says it has 'a plan.'

The Home Secretary conceded in her press conference last week that there had been “distribution issues” as a result of global demand for PPE and that there was now a “clear plan” for delivering it. She failed, however, to indicate what the 'clear plan' was. 

I have no doubt there is a plan, although it is difficult to see precisely what it is.



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