Clinical Ethics Consultation During the First COVID-19 Pandemic Surge at an Academic Medical Center: A Mixed Methods Analysis.

Autor: Erler KS; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. kerler@mgh.harvard.edu.; School of Health and Rehabilitation Science, MGH Institute of Health Professions, Boston, MA, USA. kerler@mgh.harvard.edu., Robinson EM; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.; Patient Care Services Office of Quality, Safety and Practice, Boston, MA, USA., Bandini JI; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.; RAND Corporation, Boston, MA, USA., Regel EV; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA., Zwirner M; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA., Cremens C; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., McCoy TH; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Romain F; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.; Respiratory Care, Mass General Hospital, Boston, MA, USA., Courtwright A; Optimum Care Committee, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.; Pulmonary and Critical Care Medicine, Hospital of University of Pennsylvania, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues [HEC Forum] 2023 Dec; Vol. 35 (4), pp. 371-388. Date of Electronic Publication: 2022 Mar 15.
DOI: 10.1007/s10730-022-09474-y
Abstrakt: While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim to fill this gap. Results indicate that there was no significant difference in the median number of monthly consultation cases during the first COVID-19 surge compared to the same period the year prior and that the characteristics of the ethics consults during the COVID-19 surge and same period the year prior were also similar. Through inductive analysis, we identified four themes related to ethics consults during the first COVID-19 surge including (1) prognostic difficulty for COVID-19 positive patients, (2) challenges related to visitor restrictions, (3) end of life scenarios, and (4) family members who were also positive for COVID-19. Cases were complex and often aligned with multiple themes. These patient case-related sources of ethical issues were managed against the backdrop of intense systemic ethical issues and a near lockdown of daily life. Healthcare ethics consultants can learn from this experience to enhance training to be ready for future disasters.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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