How patient age affects triage in the Covid-19 pandemic

The Author draws upon a set of guidelines issued by the Italian Society of Anaesthesia, Analgesia, Reanimation and Intensive Care (ISAARIC) and discusses the role played by patient age, at the triage stage, as the Covid-19 pandemic relentlessly unfolds. The limiting standard for admitting patients to intensive care units that best serves in terms of transparency and equality is the "first come, first served" approach; yet, in times of pandemic, patient age carries substantial weight in that selection process. In order to avoid wasting available resources and to treat as many patients as possible, therapies are discontinued for patients who do not seem to positively respond to them (as it frequently happens with elderly patients) and given to those with better chances of survival. Age is even more relevant in relation to the prognosis-based standard. Preexisting conditions, commonly associated with old age, could preclude access to intensive care. In order to avoid age-based discrimination, a) age should constitute but one standard through which the patient's chances of survival are determined; b) residual life expectancy should be disregarded; c) patients should never be cut off from receiving intensive care based on their age alone. Considering the primacy of the right to life over any other, it could be deemed ethically admissible to exclude patients, from receiving intensive care, only after the government institutions have taken any possible organizational measure, aimed at broadening health care access, while avoiding wasteful spending in the public provision of services.