“Withhold Intubation” for certain older Thammasat Hospital patients

[Thaiger]

Thammasat University Hospital, overwhelmed with Covid-19 infections, has decided to implement a fatal “Withhold Intubation Rule” for patients over 75 years old with severe conditions like incurable cancer and AIDS. The hospital is experiencing an extreme shortage of ventilators and together critical life-saving equipment, and was forced to make the tough decision that will inevitably lead to unnecessary deaths. The hospital is stressed to capacity and even the overflow field hospital hosts 392 patients, 50 of which are children, plus the 300 patients the hospital is tasked with caring for in-home isolation. Even after sending those 300 patients home in […]

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[DontacoXII]

Aka triage. In the case of incurable cancer patients saving them undue suffering and pain. 

[SickBuffalo]

This happened in the UK too, early on in the pandemic.

[AlexPTY]

Why suddenly covid patients are getting priority?  Have you ever heard of the Hippocratic Oath? 

[Rasputin]

It's only to be expected really when resources are running low, the same happens in health services everywhere. Can't help be thinking though, this is just the start of a long and probably slippery slope.

[HuaHinHappy]

What is stated  publicly and what will be done privately are two very different concepts. Unfortunately, IMO this will most likely be interpreted more broadly as was done elsewhere. This is healthcare rationing, which the Covid naysayers  obnoxiously proclaimed wasn't a concern because there were so many available hospital beds etc. I expect that we will see a great many "AIDs and metastasised incurable cancer" cases diagnosed within the next month.

53 minutes ago, DontacoXII said:

Aka triage. In the case of incurable cancer patients saving them undue suffering and pain. 

That is really not how it is done. Perhaps, you are confusing DNRO (do not resuscitate orders) with health care rationing. 

34 minutes ago, AlexPTY said:

Why suddenly covid patients are getting priority?  Have you ever heard of the Hippocratic Oath? 

Yes I have. This is not a  telly soap opera. Why would you expect a poetic vow from thousands of years ago to be appropriate for current circumstances? It was written at a time when it was normal to drill a hole in  a person's head to let a bad spirit escape or to give potions of dubious ingredients to women so that they may produce a male baby. Are you aware that;

1. The hippocratic oath has no legal standing.

2. Most medical professionals do not take a "hippocratic oath". The oath has not been used in many western countries for 30+ years. For example, it is not used in Australia.

3. Physicians are subject to licensing and this includes codes of conduct and ethical guidelines. These allow for healthcare rationing under crisis circumstances.

Hospitalised Covid patients tend to be critical care patients. This is why Covid presents such a problem to society. Yes, they monopolize healthcare and  deny  healthcare to others. However, to not give a patient the priority needed is unethical under the guidelines.  In Thailand, if a patient has Covid, that patient is most likely to be poor and a service trade or food processor worker and/or under the age of 21. One cannot expect to continue to receive services, but to then deny healthcare to those who risk their lives to provide the services. 

Under different circumstances, I agree that it would be acceptable to ration health care to the unvaccinated who chose to remain unvaccinated when given the opportunity to access a quality assured vaccine. We are not there.

Edited July 23, 2021 by HuaHinHappy

[uanmak]

Same things happened in Europe at the beginning... Thailand is 1.5 yers later... such a wasted time... shameful.

[Guevara]

2 hours ago, AlexPTY said:

Why suddenly covid patients are getting priority?  Have you ever heard of the Hippocratic Oath? 

Yes, they have heard of the Oath, sadly some of the individuals in my chosen career and profession choose not to recognize it ( selectively). It's what is generally known as playing God.

[Guevara]

2 hours ago, Rasputin said:

It's only to be expected really when resources are running low, the same happens in health services everywhere. Can't help be thinking though, this is just the start of a long and probably slippery slope.

Is that a veiled 'acceptance' until it's someone close to you?

[Guevara]

2 hours ago, uanmak said:

Same things happened in Europe at the beginning... Thailand is 1.5 yers later... such a wasted time... shameful.

You are quite right, it did happen and it was painful to experience it on the coal face. The annoying thing is the likes of Thailand had a golden opportunity to learn from others mistakes, trials and errors. I witnessed first hand their initial response in Feb 2020, it was exemplary and to be applauded. Sadly the Thai Government adopted a very laid back attitude and are now paying the price. Thailand in particular was very avoidable. Though 'Professor' Tim Weston would say otherwise. When the likes of him have worked in an isolation Hospital, he can start lecturing me. Until then, he can mince around with his Lady Boy attracting blouses.

[Guevara]

2 hours ago, HuaHinHappy said:

What is stated  publicly and what will be done privately are two very different concepts. Unfortunately, IMO this will most likely be interpreted more broadly as was done elsewhere. This is healthcare rationing, which the Covid naysayers  obnoxiously proclaimed wasn't a concern because there were so many available hospital beds etc. I expect that we will see a great many "AIDs and metastasised incurable cancer" cases diagnosed within the next month.

That is really not how it is done. Perhaps, you are confusing DNRO (do not resuscitate orders) with health care rationing. 

Yes I have. This is not a  telly soap opera. Why would you expect a poetic vow from thousands of years ago to be appropriate for current circumstances? It was written at a time when it was normal to drill a hole in  a person's head to let a bad spirit escape or to give potions of dubious ingredients to women so that they may produce a male baby. Are you aware that;

1. The hippocratic oath has no legal standing.

2. Most medical professionals do not take a "hippocratic oath". The oath has not been used in many western countries for 30+ years. For example, it is not used in Australia.

3. Physicians are subject to licensing and this includes codes of conduct and ethical guidelines. These allow for healthcare rationing under crisis circumstances.

Hospitalised Covid patients tend to be critical care patients. This is why Covid presents such a problem to society. Yes, they monopolize healthcare and  deny  healthcare to others. However, to not give a patient the priority needed is unethical under the guidelines.  In Thailand, if a patient has Covid, that patient is most likely to be poor and a service trade or food processor worker and/or under the age of 21. One cannot expect to continue to receive services, but to then deny healthcare to those who risk their lives to provide the services. 

Under different circumstances, I agree that it would be acceptable to ration health care to the unvaccinated who chose to remain unvaccinated when given the opportunity to access a quality assured vaccine. We are not there.

Would that be the transportees to Australia, you know, the pale skin, not the indigenous? Genuine Doctors continue to recognize the Oath the World over.

[Soidog]

Sadly this is the reality of any situation with finite resources. Only be grateful you are not the person having to make these toughest of decisions. 
 

It’s news like this that I guess the Covid is “just a bit of flu”, or it’s a conspiracy made up by dark forces to control the world fraternity will claim is another lie. As I said in another post, if this is what you really feel then pop along to your nearest Covid ward in Bangkok and check it out for yourself. Tragic … 

[Guevara]

2 hours ago, Rasputin said:

It's only to be expected really when resources are running low, the same happens in health services everywhere. Can't help be thinking though, this is just the start of a long and probably slippery slope.

It's no more than is expected from a Country determined to be declared a third World Country.

[MikeW]

3 hours ago, Rasputin said:

It's only to be expected really when resources are running low, the same happens in health services everywhere. Can't help be thinking though, this is just the start of a long and probably slippery slope.

Obama wanted to implement death panels as part of obama care 

[PatrickSatoLee]

34 minutes ago, Soidog said:

Sadly this is the reality of any situation with finite resources. Only be grateful you are not the person having to make these toughest of decisions. 
 

Agreed ! 

[Bangkok_Gary]

In other words, the health care system is collapsing.

[SickBuffalo]

32 minutes ago, Tornado said:

On a broader topic, many of these government-run healthcare systems were set up decades ago, can governments continue to run them?

Unfortunately, in almost all countries with a national health system, the issue has become so politicized that it is almost impossible to reform or separate out parts that might be better handled by private organizations.

The only hope is that advances in technology will render such dinosaur systems redundant.

[JamesE]

40 minutes ago, SickBuffalo said:

The only hope is that advances in technology will render such dinosaur systems redundant.

Nanobots! We could.... ummm... ummm... put them in a vaccine so you'd only need one shot. They could monitor your systems and report to... ummm... Microsoft! Yes! Microsoft! Then the data would get sold to... ummm... George Soros! <Wait... That makes no sense...> AMAZON! YES! EFFING AMAZON! and Jeff Bezos would sell you the exact drug combination to make you well! I knew it would work out.

What? "Broken arm", you say? You're just stuffed then, mate.

[shemozzel]

"Obama wanted to implement death panels as part of obama care"

The 2009 "lie of the year" from Sarah Palin.

If Sarah was to leave Alaska and move to Florida she'd increase the IQ of both states.

 

[gummy]

3 minutes ago, shemozzel said:

"Obama wanted to implement death panels as part of obama care"

The 2009 "lie of the year" from Sarah Palin.

If Sarah was to leave Alaska and move to Florida she'd increase the IQ of both states.

And that must be the best post today so far. 

[Smithydog]

8 hours ago, Soidog said:

Sadly this is the reality of any situation with finite resources. Only be grateful you are not the person having to make these toughest of decisions. 

 

Yes. Like so many things, the chat goes on in the background whilst the people faced with such choices have to make a decision, even if it does compromise their morals and ethics. I can remember this being discussed in the UK last year at an earlier stage of the Pandemic.

Total belief in an Ideal is only possible when the reality of a situation allows it. Sadly at times, someone may have to compromise their ideals. I can only hope that the medical professionals, real people, forced into such situations get effective and proper support to not only make the decision, but to deal with the residual aftereffects of their choices.

 

[HuaHinHappy]

9 hours ago, Guevara said:

Would that be the transportees to Australia, you know, the pale skin, not the indigenous? Genuine Doctors continue to recognize the Oath the World over.

Such nonsense.  Indigenous medical students follow the same curriculum as "pale skin" people.  They also follow the same curriculum of the not pale people, Apaprently you see Asian and African origin unworthy of consideration as medical students.   And no,  none of the graduates is required to take the oath because it is not part of their curriculum.  Name one of the 12 medical schools in Australia and New Zealand where medical school graduates take this oath. Nor is the oath is taken by graduates of US or Medical schools. Some graduates may choose to take a version written by Dr. Lasagna from 1964, when he was the Dean of Tufts Medical School in the USA, but these tend to be social and private events and the oath is quickly forgotten.  Save the condescending claptrap  on genuine physicians recognizing the oath the world over as you obviously know nothing. There is no Hippocratic oath in much of the world. The billions of people of China, India, Indonesia, Pakistan and Bangladesh have no desire, nor urge to follow the  nonsensical  writings of a long dead Greek.  These people rejected western moral codes long ago. China engages in  unethical and diabolical  "medical research" and has no concern for the humane treatment of lab animals and yet you expect people with common sense to believe that they follow a Hippocratic oath. Yea, right.

[dj230]

This happened in Canada too and people with essential surgeries were delayed last year, ie. cancer patients. Only thing that changed it was lockdowns and getting cases back down.

[Craig]

Well, if death is preferred vs being a vegetable for the rest of “life”, I wonder if the hospital staff pulling the plug feel “karma” will get them?  It’s too bad it takes covid to do what some wanted in the first place.  

[Faraday]

18 minutes ago, Craig said:

wonder if the hospital staff pulling the plug feel “karma”

I truly hope not.

It's not a simple case of:

"Patient in bed 4 is f***ed, best unplug him"

With empathy, & understanding the medical prognosis, they be able to see it as a compassionate act.