Every pandemic may cause the excessive demand for healthcare facilities and systems, while also increasing the workload of healthcare providers. On the other hand, the limited resources available to provide healthcare services to patients are a major challenge in this regard, which often emerges within the first days of the pandemic when the healthcare system is unexpectedly faced with a large number of patients without access to sufficient equipment, staff, and facilities. As such, the healthcare system or patients may suffer numerous consequences due to unpreparedness. Incidentally, although everyone is susceptible to a COVID-19, the elderly are more susceptible due to comorbidities and frailty. So far, the highest mortality rate of the disease has been reported in the elderly, especially those with severe illnesses and immune deficiency. Currently, no definite treatments or vaccines are available for COVID-19, and recommendations mostly revolve around self-isolation and the observance of personal hygiene. To the elderly with cognitive impairment, functional dependence, or living alone, it might be difficult to follow instructions, stay updated on the news, or detect the signs or symptoms of the infection. Consequently, these individuals may be faced with challenges in communicating and explaining their pain or uneasiness, and the newly emerging pandemic becomes a profound health hazard in their cases. This problem further strains the struggling healthcare system, leading to decisions and actions that favor the younger population over the elderly, especially since better outcomes are seen in former compared to the latter. Although many guidelines indicate that the withdrawal of limited resources from severe or terminal patients in order to save the life of others is not an act of killing, such decision causes extreme psychological traumas in the elderly population. The main issue in this regard is not the setting of priorities for receiving treatment, but rather the ambiguity about the implementation of such priorities in terms of morality and continuity as priorities must not deprive individuals of their right to live and survive (especially in vulnerable populations) based on organizational and therapeutic policies.
The Unpreparedness of the Healthcare System for the Management of COVID-19 Pandemic Leading to the Mistreatment of the Elderly: A Newly Emerging Moral Dilemma