Comment: After the triage judgment: Politics can no longer duck back

Intensive care unit

07/01/20, Essen, North Rhine-Westphalia, Germany. University Hospital Essen. Intensive care unit. View into a ward room with a ventilator for seriously ill Covid-19 patients. Doctor monitoring a patient who is connected to a lung replacement machine. Universitaetsklinikum Essen during the Corona crisis *** 01 07 20, Essen, North Rhine-Westphalia, Germany University Hospital Essen Intensive Care Unit View into a ward room with ventilator for critically ill Covid 19 patients Doctor monitoring a patient connected to a lung machine University Hospital Essen during the Corona crisis

(Foto: imago images/Ralph Lueger)

In the pandemic, politicians have achieved a certain mastery of neglecting the unpleasant. Innkeepers and employers control the 2G or 3G rule and thus more or less voluntarily make their contribution to health protection. Airlines monitor that passengers adhere to entry regulations.

And the decision about life and death in congested intensive care units is left to doctors.

This ducking away on an existential question will no longer be possible in future after the triage ruling by the Federal Constitutional Court. It is true that doctors continue to make the decision between life and death because only they have the medical competence to do so.

But the Karlsruhe judges call on the government factions to give doctors a legal framework for this that excludes discrimination against the disabled. The clinical-ethical recommendations of the medical societies would not offer sufficient protection here.

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Legislators are now faced with the difficult task of ensuring that the likelihood of surviving a severe Covid disease alone counts when deciding on intensive care treatment – but not frailty or disability.

Avoid overloading the healthcare system

The Federal Constitutional Court only had to decide on a ban on discrimination against the disabled. Existential questions also arise elsewhere – for example when cancer operations are postponed to keep hospital beds free for Covid patients. Here, too, doctors are asked to make difficult decisions every day.
There must be no right of the fittest in clinics and intensive care units – “survival of the fittest” cannot be a measure of a humanistic society. As long as there is a risk of overloading the health system, everything must be done to prevent triage situations from arising in the first place.

Anyone who complains about contact restrictions or demands relaxation of the corona rules can put themselves in the shoes of a doctor who, if in doubt, has to pull the plug on the ventilator.

However, the government cannot rest if the restrictions take effect at some point and the pandemic subsides. Then she finally has to tackle the long-term health care construction site in such a way that the intensive care units are no longer overloaded in the future. Delegating away or ducking away is basically no longer possible.

More: Constitutional judges oblige legislators to “immediate” triage regulation

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