Rationing in a Pandemic: Lessons from Italy

Lucia Craxi', Marco Vergano, Julian Savulescu, Dominic Wilkinson

Risultato della ricerca: Articlepeer review

18 Citazioni (Scopus)


In late February and early March 2020, Italy became the European epicenter of theCovid-19 pandemic. Despite increasingly stringent containment measures enforced bythe government, the health system faced an enormous pressure and extraordinaryefforts were made in order to increase overall hospital beds availability and especiallyICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced ashortage of ICU beds and resources that led to hard allocating choices. At thebeginning of March 2020, the Italian Society of Anesthesia, Analgesia, Resuscitation,and Intensive Care (SIAARTI) issued recommendations aimed at supportingphysicians in prioritizing patients when the number of critically ill patients overwhelmthe capacity of ICUs. One motivating concern for the SIAARTI guidance was that, if nobalanced and consistent allocation procedures were applied to prioritize patients, therewould be a concrete risk for unfair choices, and that the prevalent “first come, firstserved” principle would lead to many avoidable deaths. Among the drivers of decisionfor admission to ICU, age, co-morbidities and preexisting functional status wereincluded. The recommendations were criticized as ageist and potentiallydiscriminatory against elderly patients. Looking forward to the next steps, the Italianexperience can be relevant to other parts of the world that are yet to see a significantsurge of COVID 19: the need for transparent triage criteria and commonly sharedvalues, give the Italian recommendations even greater legitimacy.
Lingua originaleEnglish
pagine (da-a)325-330
Numero di pagine6
RivistaAsian Bioethics Review
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

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  • ???subjectarea.asjc.1200.1211???
  • ???subjectarea.asjc.2700.2719???


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