TY - JOUR
T1 - Scarce-Resource Allocation and Patient Triage During the COVID-19 Pandemic
T2 - JACC Review Topic of the Week
AU - Kirkpatrick, James N.
AU - Hull, Sarah C.
AU - Fedson, Savitri
AU - Mullen, Brendan
AU - Goodlin, Sarah J.
N1 - Publisher Copyright:
© 2020 American College of Cardiology Foundation
PY - 2020/7/7
Y1 - 2020/7/7
N2 - The COVID-19 pandemic and its sequelae have created scenarios of scarce medical resources, leading to the prospect that health care systems have faced or will face difficult decisions about triage, allocation, and reallocation. These decisions should be guided by ethical principles and values, should not be made before crisis standards have been declared by authorities, and, in most cases, will not be made by bedside clinicians. Do not attempt resuscitation and withholding and withdrawing decisions should be made according to standard determination of medical appropriateness and futility, but there are unique considerations during a pandemic. Transparent and clear communication is crucial, coupled with dedication to provide the best possible care to patients, including palliative care. As medical knowledge about COVID-19 grows, more will be known about prognostic factors that can guide these difficult decisions.
AB - The COVID-19 pandemic and its sequelae have created scenarios of scarce medical resources, leading to the prospect that health care systems have faced or will face difficult decisions about triage, allocation, and reallocation. These decisions should be guided by ethical principles and values, should not be made before crisis standards have been declared by authorities, and, in most cases, will not be made by bedside clinicians. Do not attempt resuscitation and withholding and withdrawing decisions should be made according to standard determination of medical appropriateness and futility, but there are unique considerations during a pandemic. Transparent and clear communication is crucial, coupled with dedication to provide the best possible care to patients, including palliative care. As medical knowledge about COVID-19 grows, more will be known about prognostic factors that can guide these difficult decisions.
KW - COVID-19
KW - end of life
KW - ethics
KW - palliative care
KW - resource allocation
UR - http://www.scopus.com/inward/record.url?scp=85086719381&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086719381&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2020.05.006
DO - 10.1016/j.jacc.2020.05.006
M3 - Review article
C2 - 32407772
AN - SCOPUS:85086719381
SN - 0735-1097
VL - 76
SP - 85
EP - 92
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 1
ER -