Cypriot hospital alarmed over covid patient's refusal

Doctors in Cyprus have sought legal consultation about a hospitalized COVID-19 patient who opposes to being intubated in case that is deemed medically necessary.

According to local media, a woman infected with coronavirus and admitted to a state hospital has told doctors she did not wish to have a breathing tube down her throat.

Although the woman’s condition was said not to have been at a stage yet when intubation and the use of a ventilator might become necessary, the hospital’s senior doctors were reportedly alarmed over her refusal to undergo such treatment if her condition were to worsen.

Earlier reports said the woman told doctors from the very beginning when she was admitted to hospital that she did not wish to be intubated. It was not clear if she volunteered the information at the time or whether she had been given an overview of her options.

Doctors have consulted hospital lawyers about their options in case they deem intubation as necessary and ordered the patient to undergo an examination by a psychiatrist, who reportedly found the woman to be of sound mind.

Local media said similar incidents in the past had been resolved without resorting to power of attorney, with reports saying in such cases Cypriot state doctors talked with their patients and persuaded them to agree to the procedure. No details were made known about the outcome of those medical procedures.

But according to Cyprus Medical Association, hospital doctors must follow professional guidelines in all cases, including those that may involve the risk of death.

Patients in possession of faculties have the right to refuse

According to Philenews, CMA president Vasos Economou said patients in full possession of their faculties have the right to refuse treatment.

“Doctors can exercise reasonable pressure but not threats like we had in the past, and there have been complaints about this,” Economou was quoted as saying.

This week experts told local media a proper refusal to be sedated and intubated by a patient of sound mind would supersede any wishes by relatives, medical opinions of doctors, or even an executive order by the state’s attorney general.

But Cypriot attorney Christos Triandafyllides pointed to a case of blood transfusion, where the attorney general got a court warrant that required the parents of a child in a medical need of blood to step aside. The parents had opposed any blood being administered to their child citing religious convictions, but doctors went ahead with the procedure after securing the warrant.

Economou said doctors have the right to intervene in cases when patients cannot decide for themselves, saying they may seek a court warrant to bypass any wishes of patients or their relatives when there is a lawful basis.

In earlier stages of the pandemic, doctors in some hospitals overseas reported unusually high death rates for coronavirus patients on ventilators, with some physicians reportedly worrying that the machines could be harming certain patients.

But the reasons for concerns were not clear, as experts said each case was unique and a lot depended on the condition of patients at the time prior to infection.