Covid-19: Quali criteri per l’accesso alle cure e la limitazione terapeutica in tempo di emergenza sanitaria? [Covid-19: Which criteria for access to intensive care and limitation of the therapeutic effort in times of health emergency?]

The paper deals with the question of identifying criteria useful to take clinical decisions concerning withdrawing or withholding life-sustaining treatments with specific attention paid to emergency situations where resources available are scarce, as was the case in the rapid spread of Covid-19 pandemic. While recognizing the increased responsibility of health care workers in relation to equal resources allocation in such dramatic circumstances, the author critically evaluates, on the one hand, the use of criteria for any aprioristic selection of patients in relation to access to treatments based on age, which is unacceptable from an ethical-legal viewpoint. On the other hand, the author maintains that life expectancy could be a useful parameter of distributive justice only if it is framed within the multifactorial assessment of appropriateness of intensive care treatments based on a case by case evaluation; and this outside of any automatic mechanism that can lead to dangerous discriminatory outcomes.