The article you just read was brought to you by a few thousand dedicated readers. Will you join them?

Thanks for coming by The Tyee and reading one of many original articles we’ll post today. Our team works hard to publish in-depth stories on topics that matter on a daily basis. Our motto is: No junk. Just good journalism.

Just as we care about the quality of our reporting, we care about making our stories accessible to all who want to read them and provide a pleasant reading experience. No intrusive ads to distract you. No paywall locking you out of an article you want to read. No clickbait to trick you into reading a sensational article.

There’s a reason why our site is unique and why we don’t have to rely on those tactics — our Tyee Builders program. Tyee Builders are readers who chip in a bit of money each month (or one-time) to our editorial budget. This amazing program allows us to pay our writers fairly, keep our focus on quality over quantity of articles, and provide a pleasant reading experience for those who visit our site.

In the past year, we’ve been able to double our staff team and boost our reporting. We invest all of the revenue we receive into producing more and better journalism. We want to keep growing, but we need your support to do it.

Fewer than 1 in 100 of our average monthly readers are signed up to Tyee Builders. If we reach 1% of our readers signing up to be Tyee Builders, we could continue to grow and do even more.

If you appreciate what The Tyee publishes and want to help us do more, please sign up to be a Tyee Builder today. You pick the amount, and you can cancel any time.

Support our growing independent newsroom and join Tyee Builders today.
Canada needs more independent media. And independent media needs you.

Did you know that most news organizations in Canada are owned by just a handful of companies? And that these companies have been shutting down newsrooms and laying off reporters continually over the past few decades?

Fact-based, credible journalism is essential to our democracy. Unlike many other newsrooms across the country, The Tyee’s independent newsroom is stable and growing.

How are we able to do this? The Tyee Builder program. Tyee Builders are readers who chip into our editorial budget so that we can keep doing what we do best: fact-based, in-depth reporting on issues that matter to our readers. No paywall. No junk. Just good journalism.

Fewer than 1 in 100 of our average monthly readers are signed up to be Tyee Builders. If we reach 1% of our readers signing up to be Tyee Builders, we could continue to grow and do even more.

If you appreciate what The Tyee publishes and want to help us do more, please sign up to be a Tyee Builder today. You pick the amount, and you can cancel any time.

Support our growing independent newsroom and join Tyee Builders today.
We value: Our readers.
Our independence. Our region.
The power of real journalism.
We're reader supported.
Get our newsletter free.
Help pay for our reporting.
News
  |  
Health
  |  
Coronavirus
  |  
BC Politics

How BC Health Workers Weigh Who Lives and Dies in a Pandemic

The province’s new ‘ethical framework’ provides guidance on making tough decisions in response to COVID-19.

Moira Wyton 8 Apr 2020 | TheTyee.ca

Moira Wyton is The Tyee’s health reporter. Follow her @moirawyton or reach her here. This reporting beat is made possible by the Local Journalism Initiative.

B.C. health officials maintain they have enough beds and ventilators to cope even if COVID-19 hits the province as hard as it struck northern Italy.

But the province has also released ethical guidelines on deciding who should get treatment if resources are stretched.

The COVID-19 ethical decision-making framework for health-care workers notes that hard decisions about who gets a ventilator or priority care could be on the horizon.

Provincial health officer Dr. Bonnie Henry said last week the framework provides “a structure for how those decisions will be made so that no single individual clinician or health-care worker will have to make those entirely terrible decisions on their own.”

The guide sets out goals including transparency, integration of consistent values and public awareness. The guidelines should also “contribute to improved health outcomes and service delivery, and maximize human and financial resources,” the document states.

But the framework also raises questions around the care vulnerable patients with other illnesses might receive should the COVID-19 pandemic stretch the health-care system beyond its limit.

The guidelines set out decision-making principles like respect, fairness and flexibility.

But it also notes the need for “utility” — with resources to be distributed “such that the maximum benefits to the greatest number will be achieved.”

Eike-Henner Kluge says that raises serious issues.

“The criterion of utility throws a monkey wrench into everything,” said Kluge, a University of Victoria philosophy professor with a focus on medical ethics.

If utility is taken as the greatest health benefit to the greatest number of people, there could a minority of patients who will not be treated, Kluge said.

“You do not want to waste resources that, in fact, will never have a successful outcome,” said Kluge, a former director of ethics and legal affairs for the Canadian Medical Association.

But applying the principle is complex.

If patients are denied treatment based on their chances of recovery, for example, that could mean older people are most affected, he said.

And decisions on who gets treatment based on whether people have other illnesses or conditions could effectively discriminate against vulnerable populations. People who are experiencing homelessness, for example, tend to have poorer overall health and could be pushed to the back of the queue.

The principle of utility could contravene other aspects of fairness, such as equality or the notion that everyone should have equal access to resources, Kluge said, particularly if it aims to maximize social or economic benefit if an individual recovers.

Henry stressed the framework “respects the value of every individual life” and is not prescriptive for individual situations.

But Kluge said that’s the difficulty with guidelines — “they’re very abstract.” That lack of clarity puts enormous strain on health-care professionals if they face difficult decisions about who gets a ventilator if supplies are scarce.

Kluge notes that resource allocation happens all the time in the health-care system.

In Canada, conversations around access are shaped by the understanding that health care is considered a social right, not a commodity.

“There’s another aspect of the right to health care, that also means we have certain duties,” he said. “As a patient or a prospective patient, I have the duty to take the best steps I can to not draw on those resources if I don’t have to.”

By physically distancing and limiting outings to only necessary errands, individuals can lower the chance that they or someone else they came in contact with will need medical care, he noted.

“Members of the public are responsible too.”  [Tyee]

Share this article

The Tyee is supported by readers like you

Join us and grow independent media in Canada

Facts matter. Get The Tyee's in-depth journalism delivered to your inbox for free.

Tyee Commenting Guidelines

Do not:

  •  Use sexist, classist, racist or homophobic language
  • Libel or defame
  • Bully, threaten, name-call or troll
  • Troll patrol. Instead, downvote, or flag suspect activity
  • Attempt to guess other commenters’ real-life identities

Do:

  • Verify facts, debunk rumours
  • Add context and background
  • Spot typos and logical fallacies
  • Highlight reporting blind spots
  • Ignore trolls and flag violations
  • Treat all with respect and curiosity
  • Stay on topic
  • Connect with each other

LATEST STORIES

The Barometer

What Issue Is Most Important to You This Election?

Take this week's poll