The Thin End

Doctors should not be coerced into risking their lives if there is a shortage of PPE, says the Royal College of Surgeons in response to the new PHE guidelines on PPE. Instead of addressing the dangerous shortage of PPE, the guidelines are being changed to enable levels of protection to be reduced. This is unacceptable. Professor Neil Mortensen, President-elect of the RCS, said: “We are deeply disturbed by this latest change to PPE guidance, which was issued without consulting expert medical bodies. After weeks of working with PHE and our sister medical royal colleges to get the PPE guidance right, this risks confusion and variation in practice across the country." It is utterly disgraceful that the new guidelines have been introduced without consultation of health care representative bodies.   Professor Mortensen continues:  “The new guidance implies that, even in the operating theatre, surgeons and their teams may not require proper PPE. This is simply unac...

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 requiri...