National health system cuts and triage decisions during the COVID-19 pandemic in Italy and Spain: ethical implications

January 15, 2021

Maurizio P Faggioni, Fermín Jesús González-Melado, Maria Luisa Di Pietro

Journal of Medical Ethics

Italy and Spain were a pair of countries with some of the most critically overwhelmed health systems around the world with this pandemic. This article analyses the unfortunate fact that such is actually no surprise since (as the numbers evidently show) their governments allocated less and less economic resources to healthcare since almost 2012. Later on, when COVID-19 appeared and the Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva (SIAARTI) as well as the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) had to come up with perhaps not the best or at least most ethical guidelines for ICU admission triage. The authors stress the importance of restructuring those kind of guidelines so that the "common good" does not remit discrimination towards vulnerable groups such as the elderly or the disabled. The text closes with an elaboration of punctual proposals focused on the planning, protection, and guiding that the health authorities may find adequate to implement for what is still ahead.

Faggioni MP, González-Melado FJ, Di Pietro ML. National health system cuts and triage decisions during the COVID-19 pandemic in Italy and Spain: ethical implications [published online ahead of print, 2021 Jan 29]. J Med Ethics. 2021;medethics-2020-106898. doi:10.1136/medethics-2020-106898

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