Lauterbach draft law: only the chance of recovery should be the decisive factor for triage

An amended draft law by Federal Health Minister Lauterbach provides that only the chances of recovery of a patient under triage conditions decide on treatment.

Lauterbach draft law: only the chance of recovery should be the decisive factor for triage

An amended draft law by Federal Health Minister Lauterbach provides that only the chances of recovery of a patient under triage conditions decide on treatment. Frailty, a disability or even sexual orientation must not play a role.

If there are not enough intensive care capacities available during a pandemic, the chances of recovery alone should be the deciding factor when allocating treatment places. The current draft law by Federal Health Minister Karl Lauterbach on so-called triage states that no one should be disadvantaged in such a selection process "because of a disability, frailty, age, ethnic origin, religion or belief, gender or sexual orientation".

With this draft law, the federal government is following "the decision of the Federal Constitutional Court," Lauterbach told the newspapers of the Funke media group. "Even in the pandemic, when capacities are tight, treatment decisions must be made exclusively based on the chances of recovery."

Medical professionals understand triage as a system of categorizing patients in which the most hopeless cases are no longer treated; the system comes into play when treatment capacity is limited and physicians must make choices about who to treat.

The draft presented by Lauterbach stipulates that once a treatment has been started, it may not be broken off because of a new patient. Lauterbach is thus rejecting the so-called ex-post triage, which was reportedly initially provided for in his original draft law. This would have meant that an intensive care treatment could be discontinued in favor of another patient with a better chance of survival if three doctors agreed. An allocation decision may “only be made on the basis of the current and short-term probability of survival of the patients concerned,” the current draft continues.

In case of doubt, which patient will be awarded the contract would have to be “mutually agreed upon by two specialists who have been practicing intensive care medicine for several years and have additional training in intensive care medicine”. They must have independently assessed the patient. If there is no agreement, “another, equally qualified medical person should be consulted and then a majority decision should be made”.

In December last year, the Federal Constitutional Court ordered the government to take immediate precautions to protect disabled people during the pandemic-related triage. Otherwise, it is to be feared that they would be disadvantaged in the allocation of intensive care treatment resources, the judges explained. Several people with disabilities and previous illnesses had complained.