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COVID-19: Ethics framework to help guide clinical decision making

8 April 2020
A framework to help with difficult decisions during the pandemic
Clinicians have turned to ethicists at the University of Sydney to help guide thinking about processes for crucial decision-making in anticipation of mounting pressure on healthcare systems due to the coronavirus.

Sydney Health Ethics in the University’s Faculty of Medicine and Health has released an ethics framework to help clinicians and hospitals make critical decisions within a clinical care setting.

As a result of COVID-19 and the increasing burden on the healthcare system and resources, clinical professionals are likely to have to make decisions in situations they have never experienced before.

Director of Sydney Health Ethics Professor Angus Dawson said the request to develop the ethical framework came amid concerns that intensive care units will be overwhelmed by COVID-19 patients.

“Once we are in a pandemic situation and we are responding to a particular event and we have constraints placed upon the resources we have, then we have to do something different," Professor Dawson told ABC’s The Drum.

The framework for making resource allocation decisions within clinical care was developed by a working party in response to a request from clinical ethicists who knew that they would soon be involved in the decision making in hospitals.

The working group involved members of Sydney Health Ethics, clinicians with expertise in intensive care, and clinical ethicists affiliated with Sydney Health Ethics from Sydney and Sweden.

The document is to help clinicians, hospital administrators and policymakers plan for the possible severe scarcity of vital medical resources during the pandemic.

Professor Dawson emphasises that the document is provided to serve as a framework, not a set of rules.

It is for clinical teams and hospitals to set up systems to make resource allocation decisions and offers help with issues to think about in that process.

Questions covered by the framework include:

  • How should we decide how to allocate scarce resources?
  • Should the standard of care for patients change in an epidemic?
  • Can research be conducted during an outbreak?
  • What are the obligations of individual clinicians?

Professor Dawson said while the framework was not exhaustive, “we hope this set of questions will help clinical professionals with some of the common and difficult situations they will face during the pandemic”.

 

Michelle Blowes

Media and Public Relations Adviser (Health)

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