Doctors Face 'Playing God' Over Who Lives or Dies If Swine Flu Overwhelms NHS
July 27, 2009
Daily Mail, UK
Thousands of patients could be denied NHS treatment and left to die under 'worst-case' emergency plans for a swine-flu epidemic.
The blueprint would force doctors to 'play God' and prioritise intensive-care treatment for those most likely to benefit - ruling out patients with problems such as advanced cancer.
Photo: Taking no chances: Football fans wearing anti-flu masks
The 'scoring' system would be introduced if half the population became infected with flu.
More than 100,000 cases were diagnosed last week alone in the UK. Although the disease has claimed 30 lives, many sufferers have experienced little more than a bad cold, raised temperature and cough.
However health experts are concerned that the H1N1 virus could mutate into something more severe.
The scale of their concern is highlighted in the Department of Health's report: Pandemic Flu - Managing Demand and Capacity in Health Care Organisations.
Detailing plans to ration hospital treatment, the report warns that if half the population were infected, 6,600 patients per week would be competing for just under 4,000 intensive-care beds.
Around 85% of those beds could already be full with day-to-day emergencies.
To allocate ventilators, beds and intensive-care equipment doctors would have to 'score' patients on their health and prognosis as well as seriousness of their conditions.
Those who failed to respond to treatment would be subject to 'reverse triage' - in which they were taken off ventilators and left in NHS 'dying rooms' with only painkillers to ease their suffering.
Patients with underlying illness such as advanced cancer or the last stage of heart, lung or liver failure - and those unlikely to survive even if they were given treatment - would not be given an intensive-care bed.
Leading doctors stressed, however, that the plans were unlikely to see the light of day and that swine flu remains a mild disease for most of those infected.
The report was published at the start of the swine-flu crisis in April, along with advice from the British Medical Association and the Intensive Care Society.
Dr Carl Waldmann, president of the Intensive Care Society, said: 'Even if we doubled intensive-care capacity, with a pandemic hitting at the level outlined in this report, we would run out of beds.
'No one wants to think about this, and thankfully we are still a long way off this situation, but the ethics of it has been a big deal for doctors.'
Photo: Prioritise: Doctors treating swine flu patients would have to 'play God.
Dr Tony Calland, chairman of the BMA's ethics committee, added: 'I seriously doubt we will get anywhere near a 50% clinical attack rate, but if 25% of the population were infected that could cause major problems for the health service.
'The Department of Health is right to address this in the report and the NHS must face the issue, but many doctors would doubtlessly feel extremely uncomfortable if they found themselves having to face these kind of decisions.'
A Health Department spokesman said: 'We can't be certain how the current pandemic will develop, but we have to prepare for the reasonable worst case. Our planning assumptions are cautious scenarios, and not predictions.'
The Department of Health's 'slow' response to the pandemic will come under fire tomorrow from a parliamentary committee.
The House of Lords Science and Technology Committee is expected to attack ministers for delays in setting up the swine flu helpline.
The service for England was launched on Thursday but under the Government's own timetable, should have been up and running at the start of the crisis.
Stressing the importance of keeping a sense of perspective, Health Secretary Andy Burnham told the Observer: 'It has been a mild virus in the vast majority of cases.
'If people are made unnecessarily anxious, it makes the lives of NHS professionals, who are already under enormous pressure, far more difficult as people become unduly worried.'
The National Flu Pandemic Service telephone hotline and website allows patients to secure the antiviral drug Tamiflu without seeing a doctor. The drug does not cure flu, but can ease its symptoms and shorten the length of sickness.
Patients are diagnosed with swine flu if they have a fever over 38C and at least two symptoms including cough, sneezing, aching limbs, runny nose and headache. Some have also suffered from vomiting and diarrhoea.
Patients are still being advised to contact GPs if they have serious underlying illnesses, are pregnant, have sick children aged under one, their condition suddenly worsens or continues to worsen after seven days - five for a child.
A Kitchen worker and a cleaner at Buckingham Palace are reported to have been diagnosed with swine flu.
And at Windsor Castle, one of the Queen's choristers who sings at St George's Chapel is believed to have contracted the illness.
Last week Prince Andrew scrapped a visit to a JCB factory in Uttoxeter, Staffordshire, because of a suspected swine flu outbreak. He was due to open the £40million plant officially and present the firm with the Queen's Award for Enterprise.