Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

Document Type

Article

Publication Date

7-2020

Identifier

DOI: 10.1080/15265161.2020.1764134

Abstract

In a crisis, societal needs take precedence over a patient's best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. But surviving babies will likely live longer, maximizing life-years. Empiric evidence demonstrates that these babies can derive significant survival benefits from ventilation when compared to adults. When "triaging" or choosing between patients, justice demands fair guidelines. Premature babies do not deserve special consideration; they deserve equal consideration. Solidarity is crucial but must consider needs specific to patient populations and avoid biases against people with disabilities and extremely premature babies.

Journal Title

The American journal of bioethics : AJOB

Volume

20

Issue

7

First Page

37

Last Page

43

MeSH Keywords

Aged; Betacoronavirus; Coronavirus Infections; Female; Humans; Infant, Extremely Premature; Infant, Newborn; Male; Pandemics; Pneumonia, Viral; Respiration, Artificial; Triage

Keywords

COVID-19; Health care delivery; ethics; justice; neonatology; rationing

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