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We should have an open talk with loved ones about virus, leading medic says

By Helen William, PA

Everyone should be having an open conversation with their loved ones about how they want to personally cope with becoming seriously ill, in the face of the coronavirus pandemic sweeping the globe, a doctor has said.

Hospitals are preparing for a surge in patients, and individuals need to think about their values and preferences around treatment, according to consultant neonatologist and Oxford University ethics professor Dominic Wilkinson.

Writing in the academic bulletin The Conversation, he suggests: "These conversations are to support our families and the doctors looking after us.

"They are crucial for people who are at higher risk of becoming unwell with the virus, for example, those who have a chronic illness or are older.

"They are also relevant for those who are middle aged and otherwise healthy, since the simple fact is that some of us will become life-threateningly ill."

This heart-to-heart chat may be a chance to talk openly about what can and cannot be expected from a healthcare service which is working above its normal capacity, he suggests.

It may be a chance to point out what is most important to you if you become seriously ill, along with the things you would find unacceptable or may not be willing to sacrifice if you were ill.

Professor Wilkinson writes: "In the face of this crisis, doctors and nurses and healthcare teams in the NHS should and will do their utmost. Every patient will be cared for.

"But some treatments may have no chance of helping, they may be highly burdensome, unpleasant and invasive. Or even if they could be helpful, they simply may not be available.

"It is important to understand that in the coming weeks some treatments will be in critically short supply."

The stark reality for some people who are admitted to hospital may be a trial period of treatment which may be reviewed and then stopped.

He notes: "The concept of a 'trial period' is so important right now because when treatment is in short supply, the duration of treatment is directly related to how many patients can be treated."

Factors such as how many people can benefit from a particular treatment or how long a piece of medical equipment will have to be in use are decisions which medics will have to make during these critical times.

Mr Wilkinson writes: "We can and should hope that treatments will be available for us when we need them. But we cannot take more than our fair share."

He adds: "These are intensely worrying times. It is hard to know what lies ahead for any of us. We should definitely hope for the best, but it is also important to have some conversations with our families now - so that we may all plan for the worst. Just in case."