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Yascha_Mounk's profile
Yascha Mounk
Yascha Mounk
Yascha Mounk
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Yascha MounkVerified account

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Founder @JoinPersuasion | Associate Prof @SAISHopkins | Contributing Editor @TheAtlantic | Senior Fellow @CFR_org | Sr. Advisor @protctdemocracy | Opinions mine

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    Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

    The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care just published the most extraordinary medical document I’ve ever seen. To help people from Germany to America understand what we’re about to face, I am publishing translated extracts here. [Thread.]

    6:27 AM - 11 Mar 2020
    • 20,461 Retweets
    • 31,300 Likes
    • Akira1952 Dusanka sivcevic Catherine JK ⏳ Marcel the Silent Sonia Suter ApellA Megan Esnaola CantinaBandGuy Kayleigh Woodward
    760 replies 20,461 retweets 31,300 likes
      1. New conversation
      2. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        Background: A week ago, Italy had so few cases of corona that it could give each stricken patient high-quality care. Today, some hospitals are so overwhelmed that they simply cannot treat every patient. They are starting to do wartime triage. Here’s the guidance for that.

        50 replies 2,268 retweets 6,222 likes
        Show this thread
      3. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        "It may be necessary to establish criteria of access to intensive care not just on the basis of clinical appropriateness but inspired by the most consensual criteria regarding distributive justice and the appropriate allocation of limited health resources."

        17 replies 886 retweets 3,765 likes
        Show this thread
      4. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        "This scenario is substantially comparable to the field of 'catastrophe medicine,' for which ethical reflection has over time stipulated many concrete guidelines for doctors and nurses facing difficult choices."

        5 replies 786 retweets 3,534 likes
        Show this thread
      5. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        "In a context of grave shortage of medical resources, the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care. It's a matter of giving priority to 'the highest hope of life and survival.'"

        31 replies 1,217 retweets 4,294 likes
        Show this thread
      6. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        Recommendations: 1) The extraordinary criteria of admission and discharge are flexible and can be adapted in accordance with the local availability of resources. These criteria apply to all patients in intensive care, not just those infected with CoVid-19.

        6 replies 633 retweets 2,828 likes
        Show this thread
      7. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        2) "Allocation is a very complex and delicate choice. […] The foreseeable increase in mortality for clinical conditions not linked to the current epidemic due to the reduction of chirurgical activity and the scarcity of resources needs to be taken into consideration."

        8 replies 609 retweets 2,643 likes
        Show this thread
      8. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        3) "It may become necessary to establish an age limit for access to intensive care. This is not a value judgments but a way to provide extremely scarce resources to those who have the highest likelihood of survival and could enjoy the largest number of life-years saved."

        73 replies 1,264 retweets 3,671 likes
        Show this thread
      9. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        "This is informed by the principle of maximizing benefits for the largest number. In case of a total saturation of resources, maintaining the criterion of 'first come, first served' would amount to a decision to exclude late-arriving patients from access to intensive care."

        11 replies 601 retweets 2,586 likes
        Show this thread
      10. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        4) "In addition to age, the presence of comorbidities needs to be carefully evaluated. It is conceivable that what might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients."

        7 replies 670 retweets 2,538 likes
        Show this thread
      11. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        "For patients for whom access to intensive care is judged inappropriate, the decision to posit a ceiling of care nevertheless needs to be explained, communicated, and documented."

        10 replies 538 retweets 2,360 likes
        Show this thread
      12. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        I spent many years sitting in seminar rooms thinking about questions of distributive justice. Let me be honest: It’s left me not one bit wiser about what to do in these kinds of dramatic circumstances. So I don’t don’t mean to pass judgment on the contents of this document.

        9 replies 562 retweets 3,370 likes
        Show this thread
      13. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        BUT here’s the point I do want everyone to take away from this: Doctors in America will likely be faced with similarly heartbreaking dilemmas very soon. But we can avoid that if we:. * Start engaging in extreme forms of social distancing * Radically expand ICU capacities

        98 replies 2,309 retweets 7,478 likes
        Show this thread
      14. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        The moral choices involved in figuring out who gets care when hospitals do not have the resources to treat all critical patients are heart-breaking. But the moral choices involved in doing what we can today to avert that situation are straightforward. Cancel everything now.

        87 replies 3,353 retweets 8,939 likes
        Show this thread
      15. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        Here is the full document. (Undoubtedly imperfect) translation of it is by me. [End.] http://www.siaarti.it/SiteAssets/News/COVID19%20-%20documenti%20SIAARTI/SIAARTI%20-%20Covid19%20-%20Raccomandazioni%20di%20etica%20clinica.pdf …

        100 replies 766 retweets 3,361 likes
        Show this thread
      16. Yascha Mounk‏Verified account @Yascha_Mounk 11 Mar 2020

        Yascha Mounk Retweeted Yascha Mounk

        https://twitter.com/Yascha_Mounk/status/1237791651231338496 …

        Yascha Mounk added,

        Yascha MounkVerified account @Yascha_Mounk
        Doctors and nurses in Italy face an impossible dilemma: who to treat and who to let die. But the moral obligation we face is very clear: We must arrest the crisis before the impossible becomes unavoidable. Cancel everything. Now. Me @TheAtlantic. https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/ …
        114 replies 717 retweets 2,072 likes
        Show this thread
      17. End of conversation

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