Doctors in ethical dilemma
Exhausted both emotionally and physically but working at full speed, doctors are facing an ethical dilemma as more and more critically ill COVID patients turn up at state hospitals in the much-beleaguered Western Province
It is heartbreak time for many doctors and nurses conscientiously performing their duty, risking their lives for COVID-19 patients. While most of them are exhausted but working at full speed, with the hospital system being overwhelmed, they have been forced to ‘play god’, in the light of limited ICU beds and beds with live-saving oxygen-providing facilities.
With some private hospitals allegedly turning away COVID-19 patients, the flood of sick people turns for help to the state
hospitals in the much- beleaguered Western Province which comprises the Colombo, Kalutara and Gampaha districts.
“Yes, it breaks our heart to make these choices, knowing for sure that the patients we keep out of the ICU would inevitably die,” said an emotional Physician, explaining that this “hard
choice” they make in consultation with the Consultant- in- charge of the ICU is taking a massive toll on their mental health.
It is an ethical dilemma, many said with much poignancy. “We are supposed to save lives, not be the judge of whom we save and whom we leave to die, due to lack of facilities.”
One described the experience of having to make such a decision. In a heavily- burdened COVID- 19 ICU, a precious bed had fallen vacant. Two elderly patients, both in their 60s, needed this bed to save their lives.
“Then came a transfer of a critically-ill 24-year-old who also needed an ICU bed. What choice did we have,” was the heartrending question posed by the doctor.
Agonizing over the decision, the ICU bed was allocated to the young person. There were, of course, no guarantees that the person would survive. What of the other two elderly patients?
They are in a normal ward and may soon be face-to-face with death, murmured the doctor who walks into the ward, hoping against hope that they are alive.
Traumatized, these healthcare staff is, as distraught families of patients somehow get their mobile numbers and keep calling them to save their mothers or fathers who are under their care. Sometimes it is a losing battle as the rising death toll indicates.
Lots of patients need oxygen, another Physician told the Sunday Times, stressing that if the Delta variant continues to spread at this rate without a curb, “we may see scenes like in India sooner than later”.
This is in addition to healthcare workers also falling victim to COVID-19 even though fully-vaccinated, it is learnt.
Whatever the reason they are being hit by the virus – due to it being in the community or the removal of masks while eating together during working hours or sharing congested and crowded restrooms – urgent action needs to be taken to prevent this. Otherwise, the hospitals will take a worse hit and may even have to close their doors to patients, many said.
Numerous doctors also conceded that “minissu asaranawela”. When people hear that they have got exposed to the virus, they are unable to do the test to confirm whether they are infected or not.“Yannathenak ne,” they said.
Even when patients go into hospital for other procedures, the wards get infected with COVID-19 and, in turn, infect these patients. Then, if they are asymptomatic or mildly symptomatic, they are asked to return home, finding their own transport and contact the Public Health Inspector ( PHI) of their area. These
patients, mostly from humble homes, go back and infect everyone at home as well.
Doctors and experts conceded that there are also many social issues that ensue when the notice is posted on the gate that a house has positive patients. In some villages, no one will get close to that house and some of the patients and their families may be starving due to their inability to stock food as they just don’t have the money, while the ground level public health workers including PHIs are also overburdened.