Coronavirus: Department of Health silent on who may be refused ventilators after BMA issues guidance in Covid-19 cases

The British Medical Association (BMA), the trade union for doctors in the UK, has issued formal guidance on the matter to members.

The News Letter has been in touch with the Department of Health (DoH) on the question since Wednesday afternoon but as yet there has been no specific comment.

Dr Tom Black, chair of BMA NI, said the new guidelines from his union are very necessary because a surge in infections is expected and community needs may exceed the capacity of the system.

“We are really worried about maintaining enough hospital beds but the real worry here is how many ventilators we will have,” he said.

The BMA advice is that priority should be given to those patients who have most urgent, least complex needs and are most likely to survive, he told the BBC on Monday.

“So really we will do an assessment on who is going to benefit from this, making sure that we don’t discriminate against anyone on the basis of age or disability, because that would be illegal.

“But at the same time, if you have someone who won’t benefit, who you know from statistics won’t benefit, and there is someone who will benefit, obviously the patient who will benefit is the one who will get the access for care.”

He added: “We do have to look and see if they have other pre-existing conditions such as heart failure, or diabetes or very severe lung disease and we have to take these factors into account if we are going to do our best to save lives.”

The guidelines say all patients should be given compassionate and dedicated medical care, including symptom management and - where patients are dying - the best available end-of-life care. However they added that it is legal and ethical to prioritise treatment where there are more patients than there are resources available. Doctors may then consider the presence and severity of other illnesses and frailty of patients.

Asked if it had any policy in place on the matter, the Belfast Health Trust responded that it was a regional query so could not be answered by one trust.

The General Medical Council (GMC), which regulates individual doctors, said it was not in a position to comment. “Clinical decisions are quite rightly judged and taken by those providing care, who we trust to apply their judgment and expertise,” it added. Both organisations and the Public Health Agency directed the query to the DoH.

Last week a GP surgery in Maesteg apologised after sending a letter asking patients with life-limiting illnesses to complete a “do not resuscitate” form if they fell ill with Covid-19.

However it is hoped NI will be able to cope, gaining an extra 230 specialist beds after Belfast City Hospital was designated a Nightingale Hospital. Further capacity is planned at Altnagelvin and Ulster Hospital if needed. NI now has 165 ventilators with further orders being progressed.

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