After criticism from the Greens – Lauterbach does not want to enable ‘post’ counting

Karl Lauterbach (Social Democratic Party), on the sidelines of the closed conference of the federal government in Schloss Messberg
Source: dpa
Should a patient’s medical treatment be discontinued for another patient with a better chance at life? The Minister of Health in Lauterbach (SPD) must regulate this issue by law. Critics have called for better protection for the disabled.
BHealth Minister Karl Lauterbach (SPD), contrary to reports, does not want a triage regulation that would allow the suspension of intensive care treatment in hospital in favor of a patient who has a better chance of survival.
Lauterbach said Monday in Berlin that this “subsequent screening is morally unacceptable”. Neither doctors, nor patients, nor relatives should be expected to do so. “That’s why we won’t allow that either,” Lauterbach added. Even screening before treatment should only be possible under strict conditions. Lauterbach said that given the Constitutional Court’s decision on triage from last year, “we have to highlight the gray area of medical decisions in the pandemic.” We will soon present an opposite bill.
“The triage decisions were a real danger in this epidemic in Germany, but they were not part of everyday life,” Lauterbach stressed. Corona measures and patient transportation made it possible to take good care of all patients. “It should stay that way in the future.”
Headwinds for first bills
According to reports, a bill from the Ministry of Health initially provided for the possibility of withdrawing intensive care treatment in favor of a patient with a better chance of survival if three doctors agreed.
However, the Green Party protested this project. “With this law, the state will not do its duty to protect,” said Corinna Rover, Member of Parliament. “People with disabilities will continue to be at risk of being excluded from intensive care treatment because of their disability,” Rover told the RND editorial network. “This means that critically ill patients have to live in the hospital with the constant fear that the medical procedures necessary to preserve life will end up in someone else’s favour.”
The Patient Protection Foundation also criticized the preliminary screening bill. “The mandate of the Federal Constitutional Court to provide better protection for the disabled in triage decisions is in no way fulfilled by transferring the decision to three private individuals,” the Board of Directors of the Patient Protection Foundation, Brech, told AFP. With a view to the planned decision by three doctors. “Three times subjective until it becomes objective.” The legislature must establish specific guidelines and criteria by which such decisions are to be made. “Staying away here will lead to a tough moral battle.”
Criticism also came from Caritas. The president of the Catholic Welfare Association, Eva Maria Welskoop-Deva, explained that the discussion would gradually change “from a tool for medical assessment in acute emergencies to legalizing the legalization of medical services according to the usefulness and quality of life.”
The Constitutional Court had requested a new regulation
At the end of last year, the Federal Constitutional Court called for a law on screening. If capabilities are scarce in a pandemic, it is possible in the future to stop intensive care treatment of a patient in favor of a patient who has a greater chance of survival. The draft screening list is still under coordination by the departments. The passage of the law regulating the so-called post-screening was and remains controversial.
It is much more sensitive than pre-screening, which involves determining which patient will receive treatment and will not receive treatment in the event of an epidemic-related deficiency. According to the proposed law, “post triage” should only be allowed if the decision was taken by three specialists with expertise in intensive care medicine by mutual agreement.
The term triage comes from war medicine and is often used synonymously with vision. Screening first gained prominence in the Napoleonic Wars in the eighteenth century. The name comes from French and means something like reading, choosing, or sorting.
Today, triage is used in disaster medicine, but also in intensive care medicine. Doctors use them in what’s called a mass casualty incident. Patients are sorted according to the urgency and severity of the disease or injury. Simply put, they are divided into three groups: people who do not need treatment, patients who no longer need treatment because they are about to die, and patients who need and benefit from medical care as well.