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10.1200/OP.20.00440

http://scihub22266oqcxt.onion/10.1200/OP.20.00440
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32853121!8258018!32853121
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suck abstract from ncbi


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pmid32853121      JCO+Oncol+Pract 2021 ; 17 (3): e369-e376
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  • COVID-19-Related Ethics Consultations at a Cancer Center in New York City: A Content Review of Ethics Consultations During the Early Stages of the Pandemic #MMPMID32853121
  • Friedman DN; Blackler L; Alici Y; Scharf AE; Chin M; Chawla S; James MC; Voigt LP
  • JCO Oncol Pract 2021[Mar]; 17 (3): e369-e376 PMID32853121show ga
  • PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has raised a variety of ethical dilemmas for health care providers. Limited data are available on how a patient's concomitant cancer diagnosis affected ethical concerns raised during the early stages of the pandemic. METHODS: We performed a retrospective review of all COVID-related ethics consultations registered in a prospectively collected ethics database at a tertiary cancer center between March 14, 2020, and April 28, 2020. Primary and secondary ethical issues, as well as important contextual factors, were identified. RESULTS: Twenty-six clinical ethics consultations were performed on 24 patients with cancer (58.3% male; median age, 65.5 years). The most common primary ethical issues were code status (n = 11), obligation to provide nonbeneficial treatment (n = 3), patient autonomy (n = 3), resource allocation (n = 3), and delivery of care wherein the risk to staff might outweigh the potential benefit to the patient (n = 3). An additional nine consultations raised concerns about staff safety in the context of likely nonbeneficial treatment as a secondary issue. Unique contextual issues identified included concerns about public safety for patients requesting discharge against medical advice (n = 3) and difficulties around decision making, especially with regard to code status because of an inability to reach surrogates (n = 3). CONCLUSION: During the early pandemic, the care of patients with cancer and COVID-19 spurred a number of ethics consultations, which were largely focused on code status. Most cases also raised concerns about staff safety in the context of limited benefit to patients, a highly unusual scenario at our institution that may have been triggered by critical supply shortages.
  • |*COVID-19[MESH]
  • |*Cancer Care Facilities[MESH]
  • |*Neoplasms[MESH]
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Carcinoma, Renal Cell[MESH]
  • |Cardiopulmonary Resuscitation/ethics[MESH]
  • |Child[MESH]
  • |Decision Making[MESH]
  • |Ethics Committees, Clinical[MESH]
  • |Ethics Consultation/*trends[MESH]
  • |Female[MESH]
  • |Health Care Rationing/ethics[MESH]
  • |Hematologic Neoplasms[MESH]
  • |Humans[MESH]
  • |Intensive Care Units[MESH]
  • |Intubation, Intratracheal/ethics[MESH]
  • |Kidney Neoplasms[MESH]
  • |Lung Neoplasms[MESH]
  • |Male[MESH]
  • |Medical Futility[MESH]
  • |Mental Competency[MESH]
  • |Middle Aged[MESH]
  • |Multiple Myeloma[MESH]
  • |New York City[MESH]
  • |Occupational Health/ethics[MESH]
  • |Patients' Rooms[MESH]
  • |Personal Autonomy[MESH]
  • |Proxy[MESH]
  • |Resuscitation Orders/*ethics[MESH]
  • |SARS-CoV-2[MESH]
  • |Sarcoma[MESH]


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