The draw of the few: the challenge of crisis guidelines for extremely scarce resources


Posted: 2021-10-07 19:00:00
J Med Ethics . 2021 Oct 6;medethics-2021-107519. doi: 10.1136/medethics-2021-107519. Online ahead of print. Affiliations Expand Affiliation 1 Psychiatry and Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA jacobmappel@gmail.com. Item in Clipboard Jacob M Appel. J Med Ethics. 2021. Show details Display options Display options Format J Med Ethics . 2021 Oct 6;medethics-2021-107519. doi: 10.1136/medethics-2021-107519. Online ahead of print. Affiliation 1 Psychiatry and Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA jacobmappel@gmail.com. Item in Clipboard CiteDisplay options Display options Format Abstract The COVID-19 pandemic has focused considerable attention on crisis standards of care (CSCs). Most public CSCs at present are effective tools for allocating scarce but not uncommon resources (like ventilators and dialysis machines). However, a different set of challenges arise with regard to extremely scarce resources (ESRs), where the number of patients in need may exceed the availability of the intervention by magnitudes of hundreds or thousands. Using the allocation of extracorporeal membrane oxygenation machines as a case study, this paper argues for a different set of CSCs specifically for ESRs and explores four principles (transparency, uniformity, equity and impact) that should shape such guidelines. Keywords: COVID-19; allocation of health care resources; end-of-life; resource allocation. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. Conflict of interest statement Competing interests: None declared. [x] Cite Copy Format: Send To [x]

参考サイト PubMed: covid-19



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