Ethics in HealthcareHealth EquityIntensive CareSMACCDebate: The ICU is no place for the elderly

Debate: The ICU is no place for the elderly

Francesca Rubulotta argues in favour of the ICU being no place for the elderly.

She describes the ICU as a horrible monster, a very dangerous place. Furthermore, she suggests the ICU is on par with climbing a mountain in terms of risk and exposure to catastrophise.

She continues to make the point that once a person reaches adulthood, the healthcare system is a one size fits all model.

This extends to the type of treatment required – whether it be for an acute or chronic condition.

Whilst hospitals, and ICU specifically, may be suited to assist those with acute conditions, it is perhaps less appropriate to deal with chronic conditions that avail the elderly.

Francesca concludes that for the elderly, there needs to be a new model.

One reliable, dedicated to the older patient population and able to provide the dignity they deserve.

Karin Amrein provides a counter argument. She bases this initially through a personal story of her grandmother. This provides the basis for her argument that advanced age does not predetermine outcomes in healthcare.

‘Elderly’ is a large spectrum and age alone is a poor individual determinate for health. At an individual level, age cannot tell one how a person will fare in the ICU, and it can be an appropriate setting for the right ‘elderly’ patient.

Karin contends that all patients are worthy of care in all settings depending on their personal context. Whilst with elderly patient one might consider conditions such as sarcopenia or dementia, this should not render them unworthy of care.

Karin suggests this is discrimination.

For Karin, age is just a number, and it is the person that should be treated – including in the ICU if appropriate.

Join Francesca Rubulotta and Karin Amrein as they debate whether ICU is a place for the elderly.

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Karin Amrein

Francesca Rubulotta