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Saturday 21 August 2021

Doctors in North Texas considered taking COVID-19 patients' vaccination status into account when determining who got ICU beds

 A North Texas doctors' group said in an email to members this week that vaccination status could be taken into account when determining which COVID-19 patients get beds in intensive-care units if the region experiences another crisis.

The memo from the North Texas Mass Critical Guidelines Task Force was leaked to The Dallas Morning News, which published details about it on Thursday.

The memo boiled down to this: Since vaccination vastly improves a person's chance of surviving COVID-19, a patient's vaccination status could count as a plus or a strike when determining whether they get an ICU bed, though it could not be the sole factor.

The guidelines were designed for a Level 3 crisis stage, which Dr. Robert Fine, a co-chair of the task force, told The Dallas Morning News could happen in two weeks. The task force's guidelines are not enforceable but are generally followed, the newspaper said.

Shortly after The Dallas Morning News published its story, a spokesperson for the task force walked back the memo.

Dr. Mark Casanova, the director of clinical ethics for Baylor University Medical Center, had told NBC Dallas-Fort Worth on Thursday that the memo was meant to help guide doctors in triaging patients in limited situations.

Hours later, he told NBC the memo was merely a "homework assignment" that members could respond to with their own suggestions.

He said that going forward, vaccination status would not be among the factors that hospitals would be told to consider when triaging patients.

"In the midst of this reconvening, and exploration and discussion with various triage committee members, the consensus is vaccination status, or more specifically a lack of a vaccine will not be considered as part of any exclusion criteria for treating patients," he told the outlet.

Dr. Harald Schmidt, a professor of medical ethics and health policy at the University of Pennsylvania, told The Dallas Morning News he found the memo problematic, especially given its implications for disadvantaged groups.

The memo said special considerations should be made for a patient who is not vaccinated for reasons "beyond the patient's control," but Schmidt said that language ignored reasons some historically or economically disadvantaged groups would not be vaccinated.

He said those included not having the means to get to vaccination appointments and having a distrust of medical authorities as a person of color.

"This policy pretends that it is just focusing on objective medical knowledge, but it ignores societal injustices," Schmidt told the newspaper. "In such cruel clarity, COVID-19 has exposed the consequences of the structural inequities that we've had so long. That's why it's critical that we don't add to that, and in this case, we risk that."

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