Fair allocation of scarce medical resources during COVID-19 pandemic: ethical considerations

Satomi, Erika; Souza, Polianna Mara Rodrigues de; Thomé, Beatriz; Reingenheim, Claudio; Werebe, Eduardo de Campos; Troster, Eduardo Juan; Scarin, Farah Christina de La Cruz; Bacha, Hélio Arthur; Grunspun, Henrique; Ferraz, Leonardo José Rolim; Bueno, Marco Aurélio Scarpinella; Filho, Mario Thadeu Leme de Barros; Borges, Pedro Custódio de Mello

doi:10.31744/einstein_journal/2020ae5775

Cited by 53 publications

(65 citation statements)

References 11 publications

(10 reference statements)

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“…Recommendation two is that the allocation of resources should be arranged to be given to health care people at the coalface of the pandemic. This position reiterates the view that priority given to health care practitioners is not due to such workers somehow having more intrinsic value compared to others but rather that they possess an instrumental value in terms of providing a crucial care response to COVID-19 (also see Persad et al, 2009, p. 426;Satomi et al, 2020, p. 3). On a related point, to facilitate the adequate supply of staff, it has been argued that health care workers may get priority of access to the vaccine for the flu in situations of a contagious outbreak (Beauchamp & Childress, 2019, p. 312).…”

Section: Recommendati On S In the Conte X T Of Covid -19mentioning

confidence: 83%

“…Finally, following recommendation two, on first reading, it would appear that Patient X, who is a nurse, should get priority. Satomi et al (2020) state that: ‘Health professionals are essential to tackle the crisis generated by the pandemic […] their care should be prioritized, aiming at a faster recovery and return to work capacity. […] The concept is to save the life of those who can save more lives […]’ (p. 2).…”

Section: Recommendations In the Context Of Covid‐19mentioning

confidence: 99%

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The principle of salvage in the context of COVID‐19

Kearns

2020

Nursing Inquiry

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The prioritisation of scarce resources has a particular urgency within the context of the COVID‐19 pandemic crisis. This paper sets out a hypothetical case of Patient X (who is a nurse) and Patient Y (who is a non‐health care worker). They are both in need of a ventilator due to COVID‐19 with the same clinical situation and expected outcomes. However, there is only one ventilator available. In addressing the question of who should get priority, the proposal is made that the answer may lie in how the pandemic is metaphorically described using military terms. If nursing is understood to take place at the ‘frontline’ in the ‘battle’ against COVID‐19, a principle of military medical ethics—namely the principle of salvage—can offer guidance on how to prioritise access to a life‐saving resource in such a situation. This principle of salvage purports a moral direction to return wounded soldiers back to duty on the battlefield. Applying this principle to the hypothetical case, this paper proposes that Patient X (who is a nurse) should get priority of access to the ventilator so that he/she can return to the ‘frontline’ in the fight against COVID‐19.

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Section: Recommendati On S In the Conte X T Of Covid -19mentioning

confidence: 83%

Section: Recommendations In the Context Of Covid‐19mentioning

confidence: 99%

The principle of salvage in the context of COVID‐19

Kearns

2020

Nursing Inquiry

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“…and professional stress. In contrast, healthcare providers need to be protected in this process, since they are fundamental to face the issue of the escalating outbreak [8].…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan

Semenova

Pivina

Khismetova

et al. 2020

J Prev Med Public Health

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Background. : The lack of advance planning in the situation of a public health emergency can lead to wastedwaste of resources and inadvertent loss of lives. This study is aimed at forecasting the needs for healthcare resources following the expansion of the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Kazakhstan, concerning focusing on hospital beds, equipment, and the professional workforce with considering in light of the developing epidemiological situation and the data on resources currently available. Methods. : We constructed the a forecast model of the epidemiological scenario via the classic susceptible-exposed-infected-removed (SEIR) approach. The WHO's World Health Organization's COVID-19 Essential Supplies Forecasting Tool was used to evaluate the healthcare resources needed for the nearest next 12 weeks. Results. : Over the forecast period, there will be 104,713 hospital admissions due to severe disease and 34,904 hospital admissions due to critical disease, in total. This will require 47,247 beds for severe disease and 1,929 beds for critical disease at the peak of the COVID-19 outbreak. Also, tThere will also be high needs for all categories of healthcare workers and for both diagnostic and treatment equipment. Thus, the countryKazakhstan faces the need for a rapid increase of in available healthcare resources and/or for finding ways of their effectiveto redistribute redistributionresources effectively. Conclusion. : Kazakhstan is will be able to reduce the rates of infections and deaths among its population by developing and following a consistent strategy targeting the COVID-19 in a number of interrelated directions.

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“…Therefore, physicians and other healthcare professionals may face a difficult decision: who out those critically ill patients will be placed on mechanical ventilation if there is not enough for all? ( 3 - 5 )…”

Section: Introductionmentioning

confidence: 99%

Challenges for the development of alternative low-cost ventilators during COVID-19 pandemic in Brazil

Suzumura

Zazula

Moriya

et al. 2020

Revista Brasileira De Terapia Intensiva

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The COVID-19 pandemic has brought concerns to managers, healthcare professionals, and the general population related to the potential mechanical ventilators’ shortage for severely ill patients. In Brazil, there are several initiatives aimed at producing alternative ventilators to cover this gap. To assist the teams that work in these initiatives, we provide a discussion of some basic concepts on physiology and respiratory mechanics, commonly used mechanical ventilation terms, the differences between triggering and cycling, the basic ventilation modes and other relevant aspects, such as mechanisms of ventilator-induced lung injury, respiratory drive, airway heating and humidification, cross-contamination risks, and aerosol dissemination. After the prototype development phase, preclinical bench-tests and animal model trials are needed to determine the safety and performance of the ventilator, following the minimum technical requirements. Next, it is mandatory going through the regulatory procedures as required by the Brazilian Health Regulatory Agency ( Agência Nacional de Vigilância Sanitária - ANVISA). The manufacturing company should be appropriately registered by ANVISA, which also must be notified about the conduction of clinical trials, following the research protocol approval by the Research Ethics Committee. The registration requisition of the ventilator with ANVISA should include a dossier containing the information described in this paper, which is not intended to cover all related matters but to provide guidance on the required procedures.

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Fair allocation of scarce medical resources during COVID-19 pandemic: ethical considerations

Cited by 53 publications

References 11 publications

The principle of salvage in the context of COVID‐19

The principle of salvage in the context of COVID‐19

Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan

Challenges for the development of alternative low-cost ventilators during COVID-19 pandemic in Brazil

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