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Ethical Framework developed for Jersey

16 April 2020

Over the past few weeks, the Government has put in place a number of measures to prepare Jersey for COVID-19. This has included:

  • More than 100 GPs beginning direct employment with Health and Community Services
  • A centralised PPE Coordination Group to monitor, order, and distribute PPE across the Island
  • A delivery of 10,000 antibody testing kits to detect immunity to the virus, with more tests due to arrive in the coming weeks
  • The construction of the Jersey Nightingale Hospital to create an additional 180 beds for patients who will be provided with acute, enhanced and ongoing levels of medical care, including oxygen provision if required
  • The opening of an Urgent Treatment Centre to manage and treat minor injuries and illnesses.

The Government has put these preparations in place to support Jersey’s health service and support the demand for critical care arising from the COVID-19 pandemic.

As an Island with a single hospital there are, however, limitations to our critical care and acute medical care facilities. These could potentially struggle if the rate of infection dramatically increased too quickly. Under a worst case scenario, there may be limitations to the treatment we can provide and our healthcare professional would be presented with difficult clinical decisions about who gets critical care and who does not.

While we are taking every step to ensure that this scenario does not arise, we also recognise that we do need to support our health care staff in making these decisions. Therefore the Government has developed an ethical framework with the guiding principle that patients who are most likely to benefit from clinical care interventions do so.

Decisions on which of our patients are provided with access to critical care, or continue to receive such care, would be made by a Central Triage Committee, using threshold criteria.

Chief Minister, Senator John Le Fondré, said: “We need to be prepared – as a Government, as healthcare professionals, as patients, and as Islanders – to face what could become difficult decisions. The Government is doing all it can to support healthcare professionals in making decisions that could affect people’s lives and this ethical framework puts fairness at the heart of care.”

The Minister for Health and Social Services, Deputy Richard Renouf, said: “Although we will provide treatment for all our patients in hospital, we might not be able to provide critical care to all those who might normally be considered for it. Therefore we have had to prepare for this situation by considering an ethical framework to be used in those difficult situations

“This ensures that every patient’s need are considered on a fair and equal basis so that we can do the most for the most.”

Medical Director for Health and Community Services, Mr Patrick Armstrong, said: “This ethical framework provides Islanders with the assurance that if demand exceeds capacity, we have put in place a process which will guide how resources are used and that the decisions taken are fair, equitable, ethical and legal.

“The ethical framework provides reassurance that healthcare professionals will not be left to make difficult decisions about who gets what treatment.

“It will ensure that as a government, employer and community, we will stand by those who potentially need to be making very difficult decisions before, during and after the event.”

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