CYIL vol. 12 (2021)

CYIL 12 (2021) CZECH EXPERT STATEMENTS ON PATIENT PRIORITISATION IN THE COVID-19… 3. International Comparison In this chapter, we will introduce selected European guidelines and compare them with the above-outlined Czech documents. We will focus on countries that are geographically close to the Czech Republic and which have issued some of the most interesting pandemic- related triage guidelines. Those of Germany, Switzerland, and Italy will be examined. 3.1 Selected European Guidelines We have shown that both Czech documents – the Statement and the Framework – have a lot in common but there are several important differences. Perhaps the crucial ones lie in the possibilities of patient prioritisation based on their age and the prioritisation based on lottery, while the former document forbids them, and the latter approves them. There has been some exchange of arguments between the authors of the said documents both on the professional platforms and in the media. 45 In a vivid, yet respectful discussion, the aims and recommendations of the documents have been compared and explained. Nevertheless, the definite answer of what is legally permissible in the Czech Republic can only be decided by the courts. That being said, the existence of several competing guidelines in one country is not at all unique or surprising. An example can be found in Italy. At the beginning of March 2020, the Italian Society of Anaesthesia, Analgesia, Reanimation and Intensive Care (SIAARTI) issued its “Clinical Ethics Recommendations for the Allocation of Intensive Care Treatments In Exceptional, Resource-Limited Circumstances”. 46 According to this document, patients with better chances of survival should be prioritised. Special criteria might be applied depending on 45 See in a chronological order as the discussion unfolded: DOLEŽAL, Tomáš. Konflikt povinností jako okolnost vylučující protiprávnost – východisko pro úvahy o možné prioritizaci pacientů v případě nedostatku zdrojů [The Conflict of Obligations as a Legal Defence – a Framework for Considerations on Possible Patient Prioritisation in Case of the Lack of Resources]. Zdravotnické právo a bioetika. (2 November 2020.) accessed 10 June 2021, DOLEŽAL, Tomáš. Pravidlo first come, first served – kde se vzalo a kdy platí [The First Come, First Served Rule – Where It Came From and When It Is Applicable]. Zdravotnické právo a bioetika. (6 November 2020.) accessed 10 June 2021, an interview with David Černý in VRTIŠKOVÁ NEJEZCHLEBOVÁ, Lenka. Los o ventilátor je férové řešení. Ministerstvo nechalo lékaře napospas v odporné situaci, říká bioetik [Lottery for a Ventilator is a Fair Solution. The Ministry has let the Physicians Down in a Disgusting Situation, Says a Bioethicist]. Deník N. (3. March 2021.) accessed 10 June 2021, ŠUSTEK, Petr, ČERNÝ, Vladimír. Vyjádření k některým mediálním ohlasům na Stanovisko ČSARIM 13/2020 [Reaction on Certain Media Responses to the Statement of the ČSARIM 13/2020]. Anesteziologie a intenzivní medicína. (2021, Vol. 32, No. 2), pp. 119–120, or DOLEŽAL, Tomáš, ČERNÝ, David, RUSINOVÁ, Kateřina, KUŘE, Josef. Odpověď [The Response]. Anesteziologie a intenzivní medicína. (2021, Vol. 32, No. 2), pp. 120–121. 46 See VERGANO, Marco, BERTOLINI, Guido, GIANNINI, Alberto, GRISTINA, Giuseppe, LIVIGNI, Sergio, MISTRALETTI, Giovanni, PETRINI, Flavia. Raccomandazioni di etica clinica per l’amissione a trattamenti intensivi e per la loro sospensione, in condizioni eccezionali di squilibrio tra necessità e risorse disponibili. SIAARTI. (6March 2020.) accessed 11 June 2021. English version under the name “Clinical Ethics Recommendations for the Allocation of Intensive Care Treatments, in Exceptional Resource- Limited Circumstances” is available at: .

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