Mexico’s Ethics on COVID-19By Miriam Bello | Tue, 04/28/2020 - 13:07
WHO itself has spoken about the difficulties of ensuring the best provision of healthcare for everyone when the world goes through a pandemic. With limited resources and an overflow of patients, setting priorities and rationing resources “means tragic choices, but these can be ethically justified.” An ethics guideline has been shared to serve as a support guide for medical facilities confronting COVID-19 globally. The complexity of ethics brings to the table considerations regarding vulnerable populations such as indigenous people, homeless and immigrant groups, but also the healthcare workers in the frontline and the emergency responders.
Lack of ventilators and hospitals beds is a reality facing all healthcare systems. An article posted by JAMA Network exposes some of the most common guidelines of ethics during a crisis, which include: excluding large groups of people with morbid conditions such as III and IV class of heart failure, severe lung disease, end-stage renal disease and severe cognitive impairment.
The New England Journal of Medicine (NEJM) posted a proposition for ethical values to guide rationing on absolutely scarcity conditions, pointing at maximizing benefits, prioritizing health workers, not allocating resources on a first-come, first-served basis, being responsive to evidence, recognizing research participation and applying the same principles to all COVID-19 and non–COVID-19 patients. According to NEJM, these recommendations could serve as a guide to create a formal protocol to follow in order to alleviate physician burden and ensure medical treatment, as they are based on the general ethical principles of WHO, linked above.
Mexico has already posted a bioethics guide for COVID-19. Some of its guidelines include prioritizing patients that have a higher change of survival with medical treatments, as well as medical staff confronting the pandemic. These guidelines will apply for critical medical treatment and ICU. If a patient needs equipment and does not qualify to get it according to these guidelines, regular medical treatment will still be given. Also, authorities highlight that having COVID-19 will not increase the chance of a patient receiving medical treatment over a patient facing other ailments.
Countries facing a serious crisis, like Italy, Spain and the US, also have ethical guidelines on COVID-19 all based on WHO’s general principles but adapting them to their contexts. This situation generates a debate on human rights during a critical context. A scholar at UNAM suggests that, in the case of Mexico, the state should first exhaust its resources on trying to respect, protect and guarantee the health of its citizens. Moreover, since the pandemic was not a surprise for the country as it was for China, Mexico could have adopted international standards and prepare to avoid a catastrophe.