The protocol for triage of patients from the COVID-19 debate

Le protocole de triage des malades de la COVID-19 fait débat

If hospitals were to overflow of patients from the COVID-19, the access protocol to the respirator by passing the disabled and people with vulnerabilities after the other citizens, supported the liberal mp Jennifer Maccarone. The experts who have participated in its elaboration to ensure that the protocol seeks instead to avoid discrimination against patients.

The mother of two children with autism, the member of parliament for Westmount-Saint-Louis is outraged. “In the event of a lack of beds in the icu during the crisis, the government is proposing to doctors a protocol for determining who will have access to a respirator or not. For example, if you have a cognitive disability severe, such as trisomy 21 or a condition of severe autism, you might have to leave your place to another person. I am outraged, I am the mother of two children with autism and I would give them my life!”, she pestered on Wednesday at the national Assembly.

Yard.Quebec, an initiative of the Société québécoise de la déficience intellectuelle, put her hand on the exclusion criteria selected by the committee of experts responsible for designing the protocol, which have not been made public.

The “cognitive impairment-severe (total inability to perform the activities of daily living and domestic independently) due to a progressive disease”, is the number of criteria that may make a patient ineligible to intensive care.

A situation “disgusting” in the eyes of the member Maccarone. “I’m upset, angry, she insists, in an interview with our parliamentary Bureau. It is shameful to say that a person’s life is worth more than another.”

The liberal demands that we remove the exclusion criteria of the protocol and that a discussion is beginning on this delicate subject.

Not applied

The minister Danielle McCann replied that this protocol was not applied in Quebec at the present time because the hospitals have not been overwhelmed to the point of having to sort the sick who are entitled to a respirator.

The minister of Health is of the opinion that the group of experts had the duty to explain his choices.

“The life of a person in situation of handicap is as important as any life of a human being”, she added.

Protect the population

President of the committee of experts, Marie-Ève Bouthillier said that the protocol seeks precisely to avoid discrimination against vulnerable people. “We saw the images of Italian doctors to cry (need to choose between patients), we, we put the guards crazy necessary to further safeguard the population and protect the doctors from these arbitrary decisions,” she said.

Dr. Joseph Dahine, intensivist and clinical expert to the protocol of triage, ensures that people with an intellectual disability or behaviour have the same rights as other citizens.

The developmental disability or disorder of the autism spectrum are not criteria of exclusion, he insists. For a person is not put under a respirator, it would be necessary to conclude that his state would be free of the artificial respiration.

A dementia of the Alzheimer type could be an example of a condition where the placing under a respirator is not desirable, since “we would not be able to wean him off mechanical ventilation, (and this person) would be condemned to live with an artificial respirator because of this dementia-there”.

Under the protocol, at least five persons should have evaluated the decision not to intubate a patient.


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