Julian Sheather

But given that they may have to make triage decisions in the future, we would like to see more

national guidance, kind of joined up guidance.

The BMA stepped into the breach.

We felt there was a clear need to prepare doctors for the kinds of problems they may have to face.

But it would be great to see more national coordinated joined up guidance should that come about.

I think one of the urgent issues here is to ensure that decisions are made on clinically relevant data and information.

One of the things we're hearing, understandably, we're hearing a lot about is deep concerns among people from the disability communities.

The very fact that they have a disability might itself disadvantage them, may mean that they are deprioritised for treatment.

We need to be absolutely clear that we identify what are the clinically relevant factors if triage becomes necessary.

And that means that clinicians need to work very closely with ethicists because those are clinically relevant factors that need to be identified.

We know, for example, that invasive treatment in ICU can be demanding, can be highly burdensome.

You wouldn't want to put people through that if they're not going to benefit from it or if the burdens are going to be overwhelming.

So it's identifying clinically relevant factors without falling foul of inappropriate and potentially unlawful discrimination.

uncertain are there are there sort of special rules or special thinking that comes into play it's an interesting i mean what ordinarily in say clinical ethics in healthcare ethics the moral focus is always on the best interests of the individual patient but if you have a finite set of life sustaining health services and you get hit by overwhelming need

You do have to morally reorientate and say, these are very finite services.

This is overwhelming need.

How do we choose between these patients, all of whom have legitimate health needs, but we can't get anywhere near meeting all of it?

How can we maximise the benefit from the resources we've got?

And that's a brutal shift.

And nobody wants to get there.