வெள்ளி, 13 மார்ச், 2020

கொரோனா ... டைனாசோரும் மனிதனும் .. இத்தாலியில் பேசுகிறார்கள் ....

https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/?fbclid=IwAR0SKxSziHhD0y6djlqosmII3h0K17M8LFJV9M5XknReqfdcWVjbqvhkdrs

A Prabhakar TheKa : டைனோசாரும்_மனிதனும்
இத்தாலில இதோ ஆரம்பிச்சிட்டாங்க. கொள்ளைநோய் பெருகும் போது வகை தொகை இல்லாம மிகக் குறைந்த கால கட்டத்திற்குள் பெரும் பகுதியை ஆட்கொள்ளும்.
அதற்கான சிகிச்சையோ அதி நவீன கருவிகளையும், திறமையானவர்களையும் கோரி நிற்கும் போது, யாருக்கு சிகிச்சை கொடுப்பது யாரை விடுவது.
இப்போ அந்த நாட்டில் அந்த சூழ்நிலைக்கு நகர்ந்திருக்காங்க. அப்படி ஒரு நாள் வரும் பொழுது நம் வாழும் இந்த வாழ்க்கையில் நீ பெருசு, நான் சிறுசு, நான் மேல கீழ எல்லாம் உடைந்து நொறுங்கி ஒன்னுமில்லாம போகும். இந்த கோவிட்-19 மனித குலத்தை பரிணாமத்தின் அடுத்தக் கட்டத்திற்கு நகருங்கடான்னு பிடிச்சு தள்ளி விட்டிருக்கு.
பயமுறுத்துவதற்காக சொல்ல வில்லை. ஆனா, இன்னும் நாம கேள்விபடப் போற விசயங்கள் டைனோசார்கள் தங்களுக்கு இந்தப் பகுத்தறியும் ஆறாம் அறிவும், அதற்கான மொழியும் இருந்திருந்தா எப்படி அந்த கடைசி நாட்களை பேசி, எழுதி வைச்சிட்டுப் போயிருக்குமோ அந்த சூழலில் மனிதகுலம் இன்று இருப்பதாக செய்திகள் வெளிவர ஆரம்பித்து வரலாற்றில் பதிய வைக்கப்படும்.
theatlantic.com Two weeks ago, Italy had 322 confirmed cases of the coronavirus. At that point, doctors in the country’s hospitals could lavish significant attention on each stricken patient.
One week ago, Italy had 2,502 cases of the virus, which causes the disease known as COVID-19. At that point, doctors in the country’s hospitals could still perform the most lifesaving functions by artificially ventilating patients who experienced acute breathing difficulties


Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air. Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of “catastrophe medicine.” Instead of providing intensive care to all patients who need it, its authors suggest, it may become necessary to follow “the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources.
 
The principle they settle upon is utilitarian. “Informed by the principle of maximizing benefits for the largest number,” they suggest that “the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”
The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: “It may become necessary to establish an age limit for access to intensive care.”
Those who are too old to have a high likelihood of recovery, or who have too low a number of “life-years” left even if they should survive, will be left to die. This sounds cruel, but the alternative, the document argues, is no better. “In case of a total saturation of resources, maintaining the criterion of ‘first come, first served’ would amount to a decision to exclude late-arriving patients from access to intensive care.”
In addition to age, doctors and nurses are also advised to take a patient’s overall state of health into account: “The presence of comorbidities needs to be carefully evaluated.” This is in part because early studies of the virus seem to suggest that patients with serious preexisting health conditions are significantly more likely to die. But it is also because patients in a worse state of overall health could require a greater share of scarce resources to survive: “What might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients
 
My academic training is in political and moral philosophy. I have spent countless hours in fancy seminar rooms discussing abstract moral dilemmas like the so-called trolley problem. If a train is barreling toward five innocent people who are tied to the tracks, and I could divert it by pulling the lever, but at the cost of killing an innocent bystander, should I do it?Part of the point of all those discussions was, supposedly, to help professionals make difficult moral choices in real-world circumstances. If you are an overworked nurse battling a novel disease under the most desperate circumstances, and you simply cannot treat everyone, however hard you try, whose life should you save?
Despite those years of theory, I must admit that I have no moral judgment to make about the extraordinary document published by those brave Italian doctors. I have not the first clue whether they are recommending the right or the wrong thing.
But if Italy is in an impossible position, the obligation facing the United States is very clear: To arrest the crisis before the impossible becomes necessary.
This means that our political leaders, the heads of business and private associations, and every one of us need to work together to accomplish two things: Radically expand the capacity of the country’s intensive-care units. And start engaging in extreme forms of social distancin
Claudio Furlan / LaPresse / AP

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