Older Lives Matter

At a Glance

launched

March, 26, 2020

status

Active

What's this about?

People have a right to access to care regardless of their age or vulnerability

take action

An Equal Right to Care

Every person is valuable and has an inherent right to life. In some countries, it is being reported that older people are being denied life-saving treatment during the Coronavirus crisis because of their age. This is wrong, and we need to ensure that care is not allocated simply based on the criteria of age. In Ireland, the HSE needs to ensure that age is NOT be the sole criteria on which medical treatment for older people is allocated.

It is now being claimed that some hospitals in the West of Ireland are using "a points system heavily weighted against the elderly to determine which patients should be sent to intensive care during the pandemic." The Sun reported that it saw guidelines established by the Saolta Hospital Group which showed that anyone who scored more than eight points in the system should not be sent to ICU - but that patients over 80 were given seven points automatically.

The HSE currently says that residents of nursing homes should be managed in their facilities and only transferred to hospital if it will "confer additional benefit". At a time when almost half the deaths from the coronavirus are amongst older people in care homes, it needs to be made clear that no-one will be denied care simply because of their age. Other criteria must also be used in any decision to undergo medical treatment, and to best protect both older people and medical staff, the HSE must make sure its ethical guidelines are, in fact, being followed.

Dr. Bernard Devalois, a palliative care doctor in Bordeaux, warned that shortages of medical treatments might lead to a "temptation to euthanasia”. While it is very unlikely that medical professionals in Ireland would ever take such measures, it is important that the right to life of older people during the pandemic is affirmed and protected.

#NoOneLeftBehind #EveryLifeMatters

Every person is valuable and has an inherent right to life. Take action below.

TAKE ACTION

Send an email to your TD to ask them to ensure that older people do not face discrimination in this crisis. Care must not be denied based solely on the criteria of age.

Find your TD here

Sample email

Dear TD,

I am a constituent of yours, and I'm writing to ask you to take positive steps to ensure older people are not discriminated against in the current crisis. As we all know, the Coronavirus crisis means that the supply of some medical resources may be limited, and some reports from other countries indicate that guidelines were issued denying sick people ventilators based on their age. This is wrong and amounts to discrimination against older people. Age must not be the sole criteria when allocating care during this pandemic.

Yours sincerely,

Petition is coming soon

We must Ensure Older People have an Equal Right to Care in Crisis

The Coronavirus pandemic has brought a new urgency to the need to reaffirm that older people have an equal right to medical care. This awareness campaign seeks to safeguard the right of older people to be treated fairly and ethically in this crisis.

To allocate care simply based on age would be discriminatory and morally wrong. Instead, other factors such as a person's general state of health and capacity to benefit from treatment must be taken into consideration. The benefit to the population as a whole as well as the individual can also be considered.

We are confident that our healthcare professionals will always seek to do the right thing, but we call on the government to ensure that guidelines are being followed so that no person is denied access to treatment in this country simply based on their age. Other criteria must always be considered when allocating scare resources in a pandemic.

#OlderLivesMatter #NoOneLeftBehind

The COVID-19 crisis

The difficulties caused by the current pandemic may mean that supplies of medical resources are under strain and may at times be rationed. Hard-pressed clinicians will sometimes need to make difficult decisions about life-saving care.

Those decisions must always be underpinned by the basic moral principles and ethics that guide all human actions, including the duty of care which our healthcare workers are carrying out so heroically.

Key to decision-making is the principle that priority of care must primarily be based on the needs of patients. We must reject any directive which seeks to base priority of care solely on the criteria of age, in the same way that factors such as income or creed would not be used to determine priority of care.

Instead, resources must be allocated on a case-by-case basis after discussion with the patient, their family and the relevant medical professionals.

The National Institute for Health and Care Excellence in the UK, for example, has issued issued a scoring chart to help doctors decide who should be admitted to critical care. It does not categorise patients by age but instead asks medical professionals to score patients on a number of criteria including underlying conditions and the severity of their illness, to see who is considered most appropriate for treatment.

These scoring charts only apply during the pandemic where medical resources may be restricted because hospitals are overwhelmed. Likewise in Ireland, the HSE's guidelines state that "no single factor (e.g. a person’s age) should be taken, in isolation, as a determining factor and decisions should not be made arbitrarily or in such a way as to result in unfair discrimination", but, given some of the worrying news reports around older people having access to life-saving care, there are serious questions about adherence to these guidelines. We MUST make sure that older people are NOT denied access to life-saving care, and the HSE needs to do more to ensure this does not happen.

Ethical guidelines

In this unprecedented situation most hospitals will have Ethics Committees who will issue guidance to doctors and nurses caring for those sick with the coronavirus.

That guidance is crucial so that decisions made are transparent and that criteria is applied fairly and consistently. Patients and their families need to understand what is happening.

Right now, many healthcare professionals are expressing concerns about the availability of Intensive Care Unit beds, and the supply equipment such as ventilators or breathing machines which may be required by patients who are seriously ill with COVID- 19.

If the situation arose for example where medical staff had to choose which patient would get a ventilator, then a decision needs to be made on pre-determined criteria - and not simply on age. The newly issued ethical guidelines from the British Medical Association, for example, says that such decisions should not solely be based on age, but must also take underlying conditions, survival probability, and severity of illness into account.

These guidelines also protect medical staff, so that they can be confident their actions are reasonable and made in accordance with the law, medical ethics, and on the best evidence available at the time, with best care for the patient being paramount.

The British Medical Association also recognises "people with an equal chance of benefiting from a resource should have an equal chance of receiving it."

What has happened in other countries

News reports from other countries has given some cause for alarm in recent days. This awareness campaign seeks to alleviate alarm and ensure the rights of older people are re-affirmed.

Israeli doctor Gai Peleg who was working in Italy told Israel's Channel 12 that staff had been ordered not to allow those over 60 access to ventilators.

Similarly, Spanish newspaper LaVanguardia, reported that it was recommended that medical staff did not use ventilators for patients older than 80.

Again, medical treatment should not be decided based solely on the criteria of age.