A drastic increase in number of patients due to a sudden outbreak and rapid spread of infectious disease can overwhelm health care systems. Shortage of medical staff and equipment may force physicians to face a tragic choice which patients receive lifesaving treatments or which patients receive priority treatment and which patients do not. Answers to this dilemma are sought by the (medical) ethics. Another question is should any “wrong” decisions give rise to criminal responsibility. In the first part of our paper we examine recommendations published by the Slovenian and foreign ethics councils and professional medical associations. The recommedations differ, in particular, in terms of decision-making criteria in life-against-life situations. In the second part, we discuss the potential legal consequences for breaching or disregarding the recommendations. When describing the process of triaging, we present our view on the classical ethical problem that the pandemic has once-again brought to forefront: should we distinguish between situations in which patients have already been placed on mechanical ventilation and situations when two or more patients require mechanical ventilation, but only one ventilator is available? We agree that ex ante collisions of duties cannot be treated in the same way as ex post collisions of duties, but for different reasons than the authors usually suggest.
COBISS.SI-ID: 40680195
This article deals with various conceptions of patients’ rights, with an emphasis on the way the often categorical understanding of these rights has changed during the Covid-19 epidemic. The change is certainly related to the individual character of patients’ rights - in the first phase of the epidemic in Slovenia, categorical conceptions of patient’s rights were shaken by the suspension of a significant part of healthcare services. The article approaches this suspension and the consequent narrowing of patients’ rights - neither of which were limited to Slovenia - by examining the relationship between the categorical commitments of deontological ethics and the commitments of consequentialism. While the article primarily addresses the Covid-19 crisis, the issues covered here may also be relevant when it comes to economic crises or even non-crisis situations. Patients’ rights, after all, are always defined by a tension between the principle of efficiency on the one hand, and the principle of preserving patients’ health on the other.
COBISS.SI-ID: 38229507
In the contribution, triggered by the Covid-19 epidemic in Slovenia, the authors examine the lively relationship between law and medicine in the case of triage or emergency medicine. With only brief referral to key criminal and civil law challenges, which they leave aside for experts in their respective fields, they try to determine the boundaries of lawful conduct of physicians and other medical professionals by interpreting relevant provisions of Slovenian Health Services Act, Medical Practitioners Act, and Patients` Rights Act. The authors focus on hard cases of triage, in which rejection or postponement of (particular) medical care may lead not only to severe or irreversible interferences with the right to health, but also to the patient`s death. They do not specifically address the provisions of the Healthcare and Health Insurance Act as they deem the sheer mention of the fact that any limitation of the right to medical services of a compulsorily insured person may represent a breach of rights and obligations stipulated within a social-insurance relationship as sufficient for this debate.
COBISS.SI-ID: 48584451