Palliating a Pandemic: “All Patients Must Be Cared For”

Abstract

In the event of an overwhelming influenza pandemic, many health care systems will implement a triage system that would potentially deny critical care treatment to some seriously ill patients. Although all triage systems have guaranteed palliative care for those who are denied critical care, no jurisdiction has yet developed a plan to accommodate the anticipated "surge" in demand for palliative care. The authors present a mathematical and ethical justification for a palliative care surge plan and outline some of the key elements that should be included in such a plan.

Upheaval in cancer care during the COVID-19 outbreak

“…Palliation is an ethical obligation and we should strive for good symptom control and comfort care for cancer patients in a pandemic [11].…”

“…To support palliative and supportive care of people with cancer, these proposed four areas (4S) for palliating a pandemic [11] can be used to guide a response but need to be adapted and considered in the context of the availability of resources and expertise in the context of lowresource settings:…”

Palliative care in the context of a pandemic: similar but different

“…The medical literature contains a number of articles about the potential role of palliative care in healthcare emergencies, 14,15 although there are limited reports about the actual role of palliative care (or specialist palliative care services) in previous healthcare emergencies. 16,17 Indeed, there is no evidence to support any specific model of palliative care in these circumstances.…”

Recomendaciones éticas para la toma de decisiones difíciles en las unidades de cuidados intensivos ante la situación excepcional de crisis por la pandemia por COVID-19: revisión rápida y consenso de expertos

“…En primer lugar, se ha constatado una cierta carencia de referencias bibliográficas específicas sobre ética en crisis epidemiológicas. A pesar de ello, es destacable que la mayor parte de las publicaciones hacen tanto énfasis en la necesidad de dotar de premisas éticas todo el proceso de asignación de recursos, como en la necesidad de ofrecer alternativas de calidad para la paliación de los síntomas en caso de mala evolución 16 .…”

“…Se ha realizado una búsqueda narrativa, encontrando 9 artículos especialmente relevantes sobre ética en la toma de decisiones ante situaciones excepcionales de crisis relacionadas con pandemias [7][8][9][10][11][12][13][14][15] . Tres han sido los artículos que en este contexto revisan aspectos específicos de la atención paliativa [16][17][18] .…”