Who should be saved first in emergency?
Dr. B.V. SAI CHANDRAN
(Querist) 14 March 2015
This query is : Resolved
I would like to know from the respected experts about the practical ethical dilemma during emergency conditions as in the following condition:
In an imaginary situation, at a Government hospital, in the emergency department, when 3 patients arrive at the same time - all of them with equal need for immediate resuscitation. The three patients are:
A - Minister of the state, B - a retired lady teacher & C - a 10 year old school going boy. Unfortunately the limited facility and resources of the hospital permit only resuscitation one patient at a time. in such case, what is the order of priority to be attended by the doctors? (in other words how to decide whose life is more important to be saved) .Are there any legal /ethical guidelines?
kindly share your thoughts. Thanks
Anirudh
(Expert) 14 March 2015
Dear Doctor,
A very good question, though imaginary.
An obvious answer is that there are no legal provisions.
As regards Ethical, it is always open to debate and discussions and again there cannot be any conclusiveness about it. (I remember the story taught to me when I was in 2nd standard of a father and very young son taking a donkey for sale - and as they listen and follow the comments of others on the wayside, they ultimately carry the donkey on their shoulders - which on seeing its own image on the water reacted violently, and as a result fell into the river and died!)
Dr J C Vashista
(Expert) 14 March 2015
A hypothetical query.
Ethically, had I been in doctor in government hospital in the circumstances, I would have preferred 10 year school going boy followed by the lady teacher and last priority for the minister.
alexander
(Expert) 14 March 2015
With due apologies to Shri Anirudh ji, I must state that the donkey story is not apt to the situation where a Doctor is faced with "life or Death' dilemma.
2 Rank and status or the Person's Bank balance in the Indian/ Swiss/foreign banks is no consideration and it must be be RUTHLESSLY discarded by the patient concerned on entering the Hospital. For a Doctor a minister and the allegedly por manual worker are both patients. And good doctors treat all the patients s King/Minister.
3. Resuscitation calls for immediate medical intervention. The Doctor must quickly assess which patient has better chance of recovery and which patient has little and no chance of recovery. The later must not attract the immediate priority for time and effort of the Concerned Doctor .
4. In normal conditions the young infants /children, old ladies,disabled,old persons and then the rest should get priorities in that order. The seriousness and physical condition of the patient may take over riding priority.
5 In the given scenario , if the medical condition of all the three patients is serious to the same degree then the following priorities should prevail.
1, 10 year school going child
2, the retired lady School Teacher
3. The Minister who may have come in his air conditioned car/ambulance accompanied by by the regular BAND BAJA of his chamchas and the gun toting security staff.
I do hope that the Dr sahib has not faced a similar situation wherein he has been asked to explain his choice of priorities
Kishor Mehta
(Expert) 14 March 2015
Sir,
It all depends on the then prevailing circumstances, set of the mind and thinking prowess of the Doctor attending, different persons may act differently in a set of given circumatances.
In an emerrgency one has to take instant decisions and try to justify the Ethics of his/her decisions only after the event.
That is Life.
Good Luck,
Kishor Mehta
Dr. B.V. SAI CHANDRAN
(Querist) 14 March 2015
Respected expert members. I thank you all of you (Mr. Anirudh, Dr. Vasishta, Mr. Alexander, Mr.Kishore, Mr. Rajendra & Mr. sunil for spending your valuable time to respond to my query. Interaction with you has helped me to shape my thoughts.
T. Kalaiselvan, Advocate
(Expert) 17 March 2015
@Author: A good, wise and matured doctor will certainly follow the ethics purely in the manner it is to be followed as per the prevailing circumstances, instead of analysing what is to be done to whom and how. There are lot of ways or methods how the priorities to be decided depending on the situation. Well, in my opinion, expert Mr. Anirudh's explanations seems to be apt enough as a reply to the way the query appeared in the first post.
