Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Varvagianni Eleni
Dissertation committee:
Μαριάννα Καραμάνου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Θεόδωρος Παπαϊωάννου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αθανάσιος Πρωτογέρου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Μωραΐτης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ελευθερία-Φωτεινή Πουλάκου–Ρεμπελάκου, Αναπληρώτρια Καθηγήτρια (Επιβλέπουσα), Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Μαρίνος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τσιάμης, Επίκουρος Καθηγητής, Σχολή Επιστημών Υγείας, Π.Θ.
Original Title:
H διαχρονική ηθική προσέγγιση της εφαρμογής του triage στην πράξη
Translated title:
The diachronic ethical approach of the implementation of triage in practice
Summary:
The announcement of 3,000 or 4,000 deaths due to COVID-19 per day, each day, has been undoubtedly shocking even if it only referred to the “isolated” from Europe USA in the beginning! Confronted with the awe of these numbers and the progression of the death rates that started to expand from one country to the other and from one continent to the other, the worldwide medical community was required to provide its healthcare response since the early days of the year 2020. The only response that could stood up against this challenge was the adoption of strict triage protocols for the prioritization of the patients entering each healthcare center as well as for the allocation of the extremely scarce resources. However, how can “triage” be defined; The word “triage” comes to us from its first use since 1717, where it was utilized to define low – quality coffee beans. Baron Dominique Jean Larrey, chief – surgeon of Napoleon, is the first one to use it in battlefields establishing the very first principle of implementing triage: “The Principle of Priority to those who have the Greater Need”. He even leads the way providing appropriate medical care irrespective of the victims’ ranking in the military, social title or nationality. Triage will evolve during the next centuries, will “be sculptured” by the big Wars and will reach our days in order to be used to all Mass Casualty and Multi Casualty Incidents, to Emergency Rooms, to Intensive Care Units, to Pandemics and whenever the needs of victims surpass the available medical and human resources. However, is triage compatible with the Hippocratic Oath commands? Can it hold if it is put against the principles of Kant’s Categorical Imperative? How does triage function with regard to the principles of the Geneva Conventions, how is triage implemented with regard to Disasters as defined in accordance with the “World Medical Association’s” Declaration of 2017 and, finally, how is the implementation of triage affected by the four principles of contemporary Bioethics, as these are established by the philosophers TL Beauchamp & JF Childress? Before we come to our conclusions, we ought to cautiously see the way in which triage is implemented during Disasters in their broader sense, in the Emergency Departments, in the Intensive Care Units, as well as during Pandemics, putting emphasis on the criteria that are implemented for the prioritization of patients. Our last concern is to investigate any criminal liability a physician might have whilst implementing triage, in order to provide full support to the physician who is required to face real medical dilemmas being frequently unprepared by the healthcare system to cope with the tragicality of their nature!
Main subject category:
Health Sciences
Keywords:
Triage, Moral dilemmas, Victims’ prioritization, Resources’ allocation, Pandemic
Number of references:
613
File:
File access is restricted only to the intranet of UoA.
Eleni Varvagianni PhD.pdf
4 MB
File access is restricted only to the intranet of UoA.
