But They Said This Would Never Happen...(?)

Coronavirus: Elderly Europeans Denied Treatment

Soeren Kern

• In addition to the ethical questions raised by the rationing of healthcare according to age, the denial of medical attention to the elderly, many of whom have paid into the social welfare system all their lives, also casts a spotlight on the shortcomings of socialized medicine in Southern Europe, where austerity measures imposed by the European Central Bank have resulted in massive budget cuts for public healthcare.
• In documents leaked to several Spanish media, the Catalan Emergency Medical Service (Servicio de Emergencias Médicas) instructed doctors, nurses and ambulance personnel to inform the families of older patients suffering from coronavirus that "death at home is the best option." ... The protocol also advised medical personnel to avoid referring to the lack of hospital beds in Catalonia.
• "My father started working at the age of 14 until he was 65. He never asked for anything. On March 18, he needed a respirator to avoid dying and was denied.... This is the Spain we have. My father's generation built this country, its reservoirs, roads, agriculture, working 14 hours a day, coming out of a postwar period. And they are being left to die." — Óscar Haro, YouTube video, March 20, 2020.
• In November 2019, two months before the coronavirus first appeared in Spain, the Spanish government revealed that nearly 700,000 patients were on a waiting list for surgeries. Nationwide, patients had to wait on average 115 days to receive surgery; in Catalonia, patients had to wait nearly six months; in Madrid patients had to wait for six weeks.
• The severity of the coronavirus crisis in Italy and Spain, where elderly patients are being allowed to die for the benefit of the young, is due in large measure to the austerity measures associated with their membership in the eurozone. The large numbers of dead, especially among the elderly, appears to be the price that Italians and Spaniards are paying to be part of a monetary union which they never should have joined.
  
  

With well over a half-million confirmed cases of Coronavirus Disease 2019 (COVID-19) in Europe, a growing number of regional medical authorities have begun issuing guidelines and protocols that call for hospitals to prioritize younger patients over those who are older.

In Italy and Spain, the two countries most affected by the coronavirus pandemic in Europe, doctors in overwhelmed intensive care units have for weeks been making life or death decisions about who receives emergency treatment. The new protocols, however, amount to government directives that instruct medical personnel effectively to abandon elderly patients to their fate.

In addition to the ethical questions raised by the rationing of healthcare according to age, the denial of medical attention to the elderly, many of whom have paid into the social welfare system all their lives, also casts a spotlight on the shortcomings of socialized medicine in Southern Europe, where austerity measures imposed by the European Central Bank have resulted in massive budget cuts for public healthcare.

In Spain, the regional government in Catalonia, an area hit hard by the coronavirus, issued a confidential protocol which effectively advises that elderly people afflicted by the coronavirus should die at home.

In documents leaked to several Spanish media outlets, the Catalan Emergency Medical Service (Servicio de Emergencias Médicas, SEM) instructed doctors, nurses and ambulance personnel to inform the families of older patients suffering from coronavirus that "death at home is the best option."

The document stated that dying at home was more humane as it avoids suffering: patients can die while surrounded by their families, something that is not possible in overcrowded hospitals. The protocol also advised medical personnel to avoid referring to the lack of hospital beds in Catalonia.

The recommendations, endorsed by the Council of Physicians' Associations in Catalonia (Consejo de Colegios de Médicos de Cataluña), stated that patients over 80 years of age should not be intubated and be offered only "oxygen mask therapy." The guidelines recommended that patients over 80 who are suffocating be administered "comfort treatment with morphine to alleviate the sensation of dyspnea."

SEM also advised healthcare professionals to optimize medical resources in the current emergency situation and "avoid admitting patients with little benefit." Medical personnel were asked to reserve the material "for those patients who can benefit the most, in terms of years of life saved."

The Catalan Minister of Health, Alba Vergés, denied that the directive discriminates against elderly patients. SEM medical director Xavier Jiménez also denied it, but he admitted that the document exists. "All we are doing is offering patients the best option for their situation," he said.

Elsewhere in Spain, the Madrid-based Spanish Society of Intensive and Critical Medical Care (Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias, SEMICYUC) recommended that maximum therapeutic efforts should be reserved for younger people with more possibilities of survival. If there is a shortage of hospital beds, people over the age of 80 or those with Alzheimer's disease should be denied treatment.

In Italy, a document prepared by a crisis management unit in the northern city of Turin also proposed that coronavirus victims aged 80 or older or those in poor health should be denied access to intensive care if there are not enough hospital beds.

In a document leaked to the British newspaper The Telegraph, the civil protection department of the Piedmont region, stated:

Back in Spain, Óscar Haro, director of a motorcycle racing team, described in a viral YouTube video how his elderly father died from coronavirus after being denied a respirator because of his age:

"My father started working at the age of 14 until he was 65. He never asked for anything. On March 18, he needed a respirator to avoid dying and was denied.... This is the Spain we have. My father's generation built this country, its reservoirs, roads, agriculture, working 14 hours a day, coming out of a postwar period. And they are being left to die.
"I do not understand how a person like my father, who has been working all of his life, contributing to social security in this country, could die because there are no respirators, because he was unable to receive treatment, because of regulations which state that with people older than 75, it is no longer interesting to take care of them and they are left to die. We are leaving to die a generation that built this country.
"We are saying that we have incredible social security, when healthcare personnel do not even have gloves to wear. This morning they had no robes or masks. I do not understand that my father, who has been together with his wife since the age of 15, was not allowed to say goodbye to her."