Is Italy sentencing its senior citizens to death amid pandemic? Israeli doctor claims so
At the time of writing, the number of confirmed cases of those in Italy infected by the novel coronavirus has reached 59,138, while the death toll stands at 5,476 people with no sign of the contagion letting up as Italy races against time to contain the outbreak.
With many healthcare professionals having to choose who to save, an Israeli doctor working in a hospital in Parma, northern Italy, has created controversy after saying the professionals no longer give respirators to those aged over 60.
In an interview with an Israeli news show, Dr Gal Peleg admitted that the situation in Italian hospitals was quite severe. He said: "The situation is not improving, but only getting worse." He added that his department makes sure terminally-ill coronavirus patients can say goodbye to their loved ones despite strict quarantine rules.
Dr Peleg revealed that due to the lack of respiratory and CPR machines, doctors are forced to make dramatic decisions about which of the patients will be given life-saving treatment. He said the provision was that patients over 60 would not be connected to respirators as such machines are limited in number.
He went on to say, "I heard from my friends and colleagues who set a bar for age after which you can't help anymore — age 60. Over the age of 60, there are fewer intubations and full anesthesia. Under that age, we help end up giving oxygen."
This is not the first time a healthcare professional in Italy has spoken about the conditions in the country as it struggles to contain the pandemic. Giacomo Grasselli, a senior Italian health official at the epicenter of Lombardy's coronavirus crisis, conducted an interview with the UK's Channel 4 to warn the rest of the world to do all they could to stop the spread of the deadly disease.
Since various equipment is in short supply, Grasselli said on treating patients, "This is a complex decision that takes into account several factors, not only the age of course but also I would say biological age, so comorbidities, other illnesses, past illnesses, current condition, health status, frailty and so on."
He continued, "In this situation of incredible mismatch between the resources we have and the number of patients we should allocate, we have to be more strict in this... triage of the patients."
"It is a fact that we will have to choose [whom to treat] and this choice will be entrusted to individual operators on the ground who may find themselves having ethical problems," a doctor working in one of Milan's largest hospitals told Politico.
"We do not want to discriminate," said Luigi Riccioni, an anesthesiologist and head of the ethical committee of Siiarti, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, who co-authored new guidelines on how to prioritize treatment of coronavirus cases in hospitals.
"We are aware that the body of an extremely fragile patient is unable to tolerate certain treatments compared to that of a healthy person." By issuing recommendations, Riccioni said he wants to ensure doctors and medical staff are not left alone "in front of such a difficult ethical choice."
Christian Salaroli, an anesthesiologist from a hospital in Bergamo, recounted scenes of wartime triage, where old patients have to be left by the wayside. He told the Italian daily Corriere della Sera, “The choice is made inside of an emergency room used for mass events, where only COVID-19 patients enter. If a person is between 80 and 95 and has severe respiratory failure, he probably won’t make it."
Dr. Peleg sought to make clarifications later, however, stating that, "60-year-olds, like any age, receive proper treatment, including oxygen. You can understand that in the present situation, it is not possible to anesthetize and connect everyone for long periods and there has to be age considerations, health considerations and considering the beds available. Machines are indeed missing. However, efforts are being made to save everyone."
He said, "Yesterday colleagues told me that there was a 60-year-old barrage for the respirator machines in Parma, which is not necessarily indicative of all of Italy. I personally have not stood the test of those who save and those who do not. Everyone gets medicine, even 120 years old."