The principle of salvage in the context of COVID‐19

The prioritisation of scarce resources has a particular urgency within the context of the COVID‐19 pandemic crisis. This paper sets out a hypothetical case of Patient X (who is a nurse) and Patient Y (who is a non‐health care worker). They are both in need of a ventilator due to COVID‐19 with the sa...

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Bibliographic Details
Published in:Nursing Inquiry 2021-01, Vol.28 (1), p.e12389-n/a
Main Author: Kearns, Alan J.
Format: Article
Language:English
Subjects:
Access
Clinical outcomes
COVID-19
COVID-19 - prevention & control
COVID-19 - psychology
COVID-19 - transmission
frontline
Health care
Humans
Intensive Care Units - organization & administration
Intensive Care Units - trends
Medical ethics
Medical personnel
military medical ethics
Military Medicine - methods
Original
Pandemics
Pandemics - prevention & control
Prioritizing
Resource Allocation - methods
Resource Allocation - standards
salvage
Salvage Therapy - psychology
Salvage Therapy - standards
Salvage Therapy - trends
Soldiers
surge capacity
triage
Urgency
Ventilators
Ventilators, Mechanical - supply & distribution
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Summary:The prioritisation of scarce resources has a particular urgency within the context of the COVID‐19 pandemic crisis. This paper sets out a hypothetical case of Patient X (who is a nurse) and Patient Y (who is a non‐health care worker). They are both in need of a ventilator due to COVID‐19 with the same clinical situation and expected outcomes. However, there is only one ventilator available. In addressing the question of who should get priority, the proposal is made that the answer may lie in how the pandemic is metaphorically described using military terms. If nursing is understood to take place at the ‘frontline’ in the ‘battle’ against COVID‐19, a principle of military medical ethics—namely the principle of salvage—can offer guidance on how to prioritise access to a life‐saving resource in such a situation. This principle of salvage purports a moral direction to return wounded soldiers back to duty on the battlefield. Applying this principle to the hypothetical case, this paper proposes that Patient X (who is a nurse) should get priority of access to the ventilator so that he/she can return to the ‘frontline’ in the fight against COVID‐19.
ISSN:1320-7881
1440-1800
1440-1800
DOI:10.1111/nin.12389