Ethical issues related to the COVID-19 pandemic in patients with cancer: experience and organisations in a French comprehensive cancer centre.

Autor:	Blot F; Ethics Committee, Gustave Roussy Institute, Villejuif, France francois.blot@gustaveroussy.fr., Dumont SN; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Vigouret-Viant L; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Verotte N; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Rossignol J; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Rieutord A; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Fournier-Bidoz N; Ethics Committee, Gustave Roussy Institute, Villejuif, France., De Jésus A; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Dauchy S; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Chardonnet F; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Baldini C; Ethics Committee, Gustave Roussy Institute, Villejuif, France., Altea A; Ethics Committee, Gustave Roussy Institute, Villejuif, France.
Jazyk:	angličtina
Zdroj:	BMJ supportive & palliative care [BMJ Support Palliat Care] 2022 Dec; Vol. 12 (4), pp. 413-420. Date of Electronic Publication: 2020 Aug 27.
DOI:	10.1136/bmjspcare-2020-002504
Abstrakt:	Background: The COVID-19 pandemic has aggressively reached the most vulnerable, not only the elderly but also patients with chronic conditions such as cancer. In this study, we present the outlines of ethical thinking and the measures implemented to try to respect our basic values of care, in the specific environment of an oncology hospital. Methods: Our ethics committee created an ethical watch system based on 24/7 shifts to assist practitioners in their daily decisions. We discuss the challenges faced by patients with cancer during the pandemic, such as access to critical care and ethical dilemmas in the context of resource scarcity, as well as the issue of isolation of patients. We also debate the restrictions in access to oncology care in a health context strongly 'prioritised' against COVID-19. Results: In all areas of an ethical dilemma, either for sorting out access to critical care or for the dramatic consequences of prolonged isolation of patients, our common thread was our attempt to protect, whenever possible, the principles of deontological ethics by strictly resisting utilitarian pressure. Respecting democratic health decision-making processes is a cornerstone of ethically relevant decisions, including in the context of a sanitary crisis. Conclusion: The role of an ethics committee related to real-life situations includes not only a reflexive perspective in respect of fundamental principles, but also the help to enlighten and resolve ethical dilemmas in complex clinical situations. This ethical watch team assists physicians in decision-making, promoting the supportive and palliative dimension of care with a holistic approach. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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