CYIL vol. 12 (2021)

CYIL 12 (2021) CZECH EXPERT STATEMENTS ON PATIENT PRIORITISATION IN THE COVID-19… health resources in a crisis. Not even the Pandemic Plan of the Czech Republic from 2011 5 contained specific and directly applicable rules. The need for defining criteria for a pandemic- related patient prioritisation was pressing. In November 2021, a statement was issued by the Czech Society of Anaesthesiology and Intensive Care Medicine (ČSARIM) of the Czech Medical Association of J. E. Purkyně alongside several other professional societies. 6 Taking the form of the Statement of the Committee of the ČSARIM, the full name of the document was “Decision-making in patients in Intensive Care in the Situation of Lack of Scarce Resources” 7 (Statement). The team of authors was led by an intensive care expert and then-Deputy Minister of Health Vladimír Černý with intensive care physician Renata Černá Pařízková and further contained a number of leading experts on medicine, law, and medical ethics. As an attachment to the Statement, there was published the “Legal Analysis of the Situations of the Lack of Scarce Resources in the Health Care System” written by some of the Statement’s authors. 8 The Statement encompasses a fundamental factual and value framework for patient prioritisation as well as more particular principles. It stresses that these principles are not only applicable in the context of the current pandemic but also to any other mass catastrophe or disaster. 9 Its scope is narrowed to focus primarily on intensive care resources since their shortage was likely to be most pressing at the time. The limitations to other types of care, albeit important and affecting the health of many, were not included in the scope of the Statement. Among the fundamental framework for scarce resources allocation, the Statement reminds that the provision of all health services must be compliant with the basic ethical principles of medicine, e.g., the respect to patient’s autonomy, beneficence, nonmaleficence, justice, and dignity. 10 It is a direct reference to Childress’ and Beauchamp’s principlism 11 as arguably the most influential contemporary theory of medical ethics. The Statement further stresses that human life is finite. 12 While such a claim may seem obvious, it is a relevant 5 Ministry of Health of the Czech Republic. The Pandemic Plan of the Czech Republic. (2011.) accessed 10 June 2021. 6 The Czech Society of Intensive Care Medicine, the Czech Society for Infectious Diseases, and the Czech Pneumological and Phthiseological Society, all being parts of the Czech Medical Association of J. E. Purkyně. 7 ČERNÁ PAŘÍZKOVÁ, Renata, ŠUSTEK, Petr, PRUDIL, Lukáš, KOPSA T ŠINOVÁ, Jolana, ŠOLC, Martin, CVACHOVEC, Karel, DOSTÁL, Ondřej, HOLČAPEK, Tomáš, VÁCHA, Marek, ŠEVČÍK, Pavel, ČERNÝ, Vladimír. Stanovisko výboru ČSARIM 13/2020: Rozhodování u pacientů v intenzivní péči v situaci nedostatku vzácných zdrojů [Decision-making in patients in Intensive Care in the Situation of Lack of Scarce Resources]. Anesteziologie a intenzivní medicína. (2020, Vol. 31, No. 5), pp. 249–251. 8 ŠUSTEK, Petr, HOLČAPEK, Tomáš, ŠOLC, Martin. Příloha 1: Právní rozbor situace nedostatku vzácných zdrojů v systému zdravotní péče [Attachment 1: Legal Analysis of the Situations of the Lack of Scarce Resources in the Health Care System]. Anesteziologie a intenzivní medicína. (2020, Vol. 31, No. 5), pp. 252–255. 9 See ČERNÁ PAŘÍZKOVÁ, Renata, ŠUSTEK, Petr, PRUDIL, Lukáš, KOPSA T ŠINOVÁ, Jolana, ŠOLC, Martin, CVACHOVEC, Karel, DOSTÁL, Ondřej, HOLČAPEK, Tomáš, VÁCHA, Marek, ŠEVČÍK, Pavel, ČERNÝ, Vladimír. Stanovisko výboru ČSARIM 13/2020: Rozhodování u pacientů v intenzivní péči v situaci nedostatku vzácných zdrojů [Decision-making in patients in Intensive Care in the Situation of Lack of Scarce Resources]. Anesteziologie a intenzivní medicína. (2020, Vol. 31, No. 5), p. 250. 10 See ibid., p. 250. 11 See BEAUCHAMP, Tom L., CHILDRESS, James F. Principles of Biomedical Ethics. 7 th ed. Oxford University Press, Oxford 2013. 12 See ČERNÁ PAŘÍZKOVÁ, Renata, ŠUSTEK, Petr, PRUDIL, Lukáš, KOPSA T ŠINOVÁ, Jolana, ŠOLC, Martin, CVACHOVEC, Karel, DOSTÁL, Ondřej, HOLČAPEK, Tomáš, VÁCHA, Marek, ŠEVČÍK, Pavel, ČERNÝ,

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