ITU doctors can ‘phone a friend’ for ethical advice

BURNT-OUT intensive care doctors are using a new “phone a friend” service to help them make life and death coronavirus decisions, The Daily Telegraph has learnt.

At least four London hospitals and others across the country are using new systems to allow doctors to call more senior colleagues for help making ethical decisions during the pandemic.

One version at the Imperial College Healthcare Trust allows ITU doctors to summon a panel of consultants for a video conference within half an hour, 24 hours a day.

The service has also been developed at the London Nightingale hospital in the EXCEL centre, which is currently in “hibernation”, and its parent trust, Barts.

Doctors working on intensive care wards must make ethical decisions about the rationing of drugs where there are shortages, or whether to take patients off of ventilators.

Guidance by the British Medical Association warns that during the pandemic doctors are “working at or even beyond the ordinary limits of their competence or expertise” and will be “concerned about their ability to provide safe and ethical care”.

“They will also be concerned that their actions may attract criminal, civil or professional liability,” it adds.

A global shortage of remdesivir, the coronavirus “wonder drug” has led to restrictions in UK hospitals over the past week. When doctors are concerned about ethical choices or need a second opinion, they can call what is known as a “three-wise-person” panel.

Dr Dominique Allwood, assistant director of improvement at The Health Foundation charity, said the service would continue after the pandemic is over. “There are lots of difficult decisions to make during a pandemic about what care is the right care to give, because there are uncertainties about treating Covid,” she told The Telegraph.

“We haven’t had the evidence base – it has been building as it has gone on.”