AGS Releases New Statement With Strategies to Address Scarce Resources

The American Geriatrics Society (AGS) has released a new statement amid COVID-19. In this statement, AGS addresses “how society should allocate scarce resources during a crisis.”

“A just society strives to treat all people equally, so there’s something particularly unjust about characteristics beyond our control—like age—determining whether we receive care,” Timothy W. Farrell, MD, AGSF, who led the writing group responsible for the statement, explained. “The AGS believes we must focus on the most relevant clinical factors for each person and case when considering how to distribute resources fairly without placing arbitrary weight on age.”

As it is well known, the current COVID-19 pandemic is severely impacting the older adult population. In addition, there are massive concerns about the following shortages of ventilators and hospitals beds, as well as other supplies. In order to address these shortages, the focus has switched regarding decision-making, and focuses on who gets access to these resources.  

“Unfortunately, some strategies use age as an arbitrary criterion, which disfavors older adults regardless of their function and health relative to COVID-19,” said AGS President Annie Medina-Walpole, MD, AGSF. “With this statement, we hope to support hospitals, health systems, and policymakers as they develop resource allocation strategies for use in emergent situations that do not rely on age as a criterion.”

Based upon existing recommendations and research, a panel of experts developed seven principles that help to develop strategies to allocate resources that remain in short supply.

Below are highlights of the newly defined seven principles. Please refer to the reference¹ to see the detailed principles.

The seven principles touch upon:

1. Addressing age as a “means for categorically excluding someone from what is ordinarily the standard of care, nor should age “cut-offs” be used in allocation strategies;”
2. Careful consideration of various social determinants of health when assessing comorbidities;
3. Strategies that should be considered when weighing how severe comorbidities and survival in hospital might contribute to the short-term risk for death;
4. Avoiding bias in decisions making;
5. The careful selection of both committees and officers who triage the patients;
6. The development of resource allocation strategies that are transparent and applied uniformly; and
7. The importance of advanced care planning.

“Health care is unlike other ‘goods’ or services in that it’s a prerequisite for pursuing virtually every other opportunity that makes life meaningful,” Dr Farrell concluded.

“Our position statement is aimed at recognizing resource allocation shouldn’t be a question of ‘if’ but rather how we can make decisions safely and smartly, making good on our societal commitment to treat all people fairly.”

—Julie Gould

Reference:

1. The American Geriatrics Society. New AGS position statement addresses one of health care’s most difficult issues: allocating scare resources in the covid-19 era [press release]. https://www.americangeriatrics.org/media-center/news/new-ags-position-statement-addresses-one-health-cares-most-difficult-issues. May 6, 2020.