Although swine flu has temporarily abated, the current medical wisdom is that it will re-emerge with a vengeance in the autumn of this year. If it does or in the event of an alternative pandemic outbreak, there is a possibility that demand for critical care services will swamp capacity.
At this point, inception of a triage system is likely to be required, as suggested in the Department of Health’s own pandemic flu guidance.
Triage will operate both to determine who should be admitted to critical care facilities and who should remain in those facilities. This poses stark ethical problems, already the subject of discussion by the Committee on the Ethical Aspects of Pandemic Influenza (CEAPI), set up by the Department of Health.
Allocating resources
The English courts have long recognised that health bodies are required to make difficult decisions about the allocation of scarce resources: see, for instance, R v Cambridge Health Authority ex parte B [1995] 2 All ER 129, [1995] 1 WLR 898.
However, as far as we are aware, they have
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