Canada has been living in the context of a pandemic for the past two years which has led to a dramatic increase in the number of COVID-19 cases and, as a result, of hospital admissions. The high number of people requiring intensive care is coupled with resource scarcity, both human and material. As a result, health care teams are faced with difficult choices when prioritizing intensive care resources to patients who need them most. To facilitate these decisions and to save as many lives as possible, patient prioritization protocols for intensive care resources have been developed in Quebec and Ontario. Prioritization is based on criteria that determine patients’ chances of survival and other principles when survival outcomes are equal. While these protocols are intended to ensure fair and equitable treatment for all, they also raise several ethical issues, as they may disadvantage certain groups of people, or be a source of distress for families and care teams.
Fortunately, these protocols have not been implemented, and the public has not been consulted to date.
The selection of patients who would be given priority for access to intensive care beds and resources is a significant responsibility that society must consider and debate before it occurs. This is why a research team of 12 researchers funded by the Canadian Institutes of Health Research is proposing to gather public input on the subject.
On May 28 and June 4, 2022, two groups of thirty citizens from Quebec and Ontario will meet to participate in an extraordinary democratic deliberation exercise to answer the question: How do we choose who would have access to intensive care units in the extreme context of a pandemic? Under what criteria?