COVID-19: Legal implications for critical care

N. Coghlan, D Archard, P Sipanoun, T Hayes, B Baharlo

Research output: Contribution to journalArticle

Abstract

The COVID-19 pandemic has caused an unprecedented challenge for the provision of critical care. Anticipating an unsustainable burden on the health service, the UK government introduced numerous legislative measures culminating in the Coronavirus Act, which interfere with existing legislation and rights. However, the existing standards and legal frameworks relevant to critical care clinicians are not extinguished but anticipated to adapt to a new context. This new context influences the standard of care that can be reasonably provided and yields numerous human rights considerations, for example in the use of restraints or the restrictions placed upon patients and visitors under the Infection Prevention and Control guidance. The changing landscape, has also highlighted previously unrecognised legal dilemmas. The perceived difficulties in the provision of PPE for employees pose a legal risk for trusts and a regulatory risk for clinicians. The spectre of rationing critical care poses a number of legal issues. Notably, the flux between clinical decisions based on best interests towards decisions explicitly based on resource considerations should be underpinned by an authoritative public policy decision to preserve legitimacy and lawfulness. Such a policy should be medically coherent, legally robust and ethically justified. The current crisis yields numerous challenges for clinicians aspiring to remain faithful to medico-legal and human rights principles developed over many decades, especially when such considerations could easily be dismissed. However, it is exactly at such times that these principles are needed the most and clinicians play a disproportionate role in safeguarding such principles for the most vulnerable.

Original languageEnglish
JournalAnaesthesia
Early online date23 May 2020
DOIs
Publication statusEarly online date - 23 May 2020

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