Reflexions de futur i compromís de les infermeres arran de la pandèmia de la COVID-19. Comissió Deontològica COIB
Ethical guidance published for frontline staff dealing with pandemic. Royal College of Physicians
COVID-19: FAQs about ethics. BMA.
Intensive Care Society (ICS) Guidance on decision-making under pandemic conditions
DECLARACIÓN DEL COMITÉ DE BIOÉTICA DE ESPAÑA SOBRE EL DERECHO Y DEBER DE FACILITAR EL ACOMPAÑAMIENTO Y LA ASISTENCIA ESPIRITUAL A LOS PACIENTES CON COVID-19 AL FINAL DE SUS VIDAS Y EN SITUACIONES DE ESPECIAL VULNERABILIDAD. COMITE DE BIOETICA DE ESPAÑA.
Solidarity and Responsibility during the Coronavirus Crisis AD HOC RECOMMENDATION. GERMAN ETHICS COUNCIL
Orientación y estrategias para agilizar la revisión y supervisión éticas de investigaciones relacionadas con COVID-19. Organización Panamericana para la salud.
Statement on European Solidarity and the Protection of Fundamental Rights in the COVID-19 Pandemic. EUROPEAN GROUP ON ETHICS IN SCIENCE AND NEW TECHNOLOGIES.
Guidance for research in response to humanitarian emergencies. Maru Mormina, Ruth Horn, Nina Hallowell, Rosemary Musesengwa, Sapfo Lingou, Joseph Nguye. De Wellcome Centre for Ethics and Humanities, University of Oxford.
Decision Making for Intensive Care Triage in COVID-19 Emergency. A Practical Guide for Clinicians and Hospital Managers. Daniel Sokol.
Informe del Ministerio de Sanidad sobre los aspectos éticos en situaciones de pandemia: ElSARS-CoV-2
NICE Guideline: Supporting Clinical Decision Making. National Health Service
Informe del Comité de Bioética de España sobre los aspectos bioéticos de la priorización de recursos sanitarios en el contexto de la crisis del coronavirus
Consideracions sobre la limitació de recursos i decisions clíniques en la pandèmia COVID19. Comitè de Bioètica de Catalunya
Dilemes ètics al voltant del COVID-19. Grup ètica de la CAMFiC
Pandemia y fraternidad universal. Pontificia Academia para la Vida
Crisis sanitaria causada por el COVID-19. Algunas consideraciones éticas. Consello de Bioética de Galicia
DOCUMENT DE POSICIÓ CAMFIC (Societat Catalana de Medicina Familiar i Comunitària) I AIFICC (Associació d’Infermeria Familiar i Comunitària de Catalunya) DAVANT LA PANDEMIA PER SARS-COV-2
CRITERIOS DE ATENCIÓN CLÍNICA Y DE DERIVACIÓN HOSPITALARIA DE PACIENTES DIAGNOSTICADOS COMO CASOS PROBABLES DE INFECCIÓN POR SARS-CoV-2. SemFYC (Sociedad Española de Medicina de Familia y Comunitaria)
LES CURES PAL·LIATIVES DURANT UNA EMERGÈNCIA DE SALUT – PANDÈMIA COVID-19. SOCIETAT CATALANO-BALEAR DE CURES PAL.LIATIVES
MARCO ÉTICO PANDEMIA COVID 19. Sociedad Española de Anestesiología, Reanimación y Terapéutica del dolor (SEDAR)
RECOMANACIONS GENERALS relacionades amb les DECISIONS ÈTIQUES DIFÍCILS i la ADEQUACIÓ DE LA INTENSITAT ASSISTENCIAL / ingrés en les UNITATS DE CURES INTENSIVES en SITUACIONS EXCEPCIONALS DE CRISI
Consensus document about adjusting of therapeutic intensity. We share with you the final version of the document, endorsed by 18 scientific societies, 4 bioethics or palliative care centers, as well as professional colleges and research groups. It is a framework for making difficult ethical decisions in the face of need for intensive action, which we hope will be of help to all professionals and planners.
Plan de Contingencia para los Servicios de Medicina Intensiva frente a la pandemia COVID-19. Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC) y Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC)
The Spanish Society of Critical Intensive Care and Coronary Units (SEMICYUC) and the Spanish Society of Intensive Nursing and Coronary Units (SEEIUC) have published a Contingency Plan for the Services of Intensive Care Medicine against the COVID-19 pandemic. The goals are:
- Providing health authorities and clinicians with a technical document that addresses all aspects involved in the identification of care needs of serious patients in the case of the new SARS-Cov-2 virus pandemic, for a comprehensive and realistic planning of Intensive Care service at national and regional level and in each hospital.
- Seeking optimum care for patients suffering serious COVID-19, and for the rest of critical patients with other pathologies.
- Limiting the nosocomial spread of COVID-19 for:
Protecting health and non-health staff of all Intensive Care Units (ICUs)
Avoiding the hospital becomes an amplifier of the disease
Protecting non-COVID-19 patients from infection, in order to maintain the ability to provide essential non-COVID-19 medical care.
- Optimizing the human resources of the Intensive Care Services.
- Allocating limited healthcare resources in a rational, ethical and organized way to do the greater good for the greater number of people.
The document summarizes The current situation of the pandemic and raises the various possible scenarios; defines the various stages of response to the pandemic; establishes the needs of technical and human resources and defines strategies for their optimization; and establishes the indications for admission to the ICU; defines an expansion plan for intensive care services and transfer conditions for patients affected by COVID-19.
Reliable medical information Website, which offers useful information for both citizens and healthcare staff. Multiple hospitals participate, including the Sant Joan de Déu Hospital in Esplugues, as well as professional colleges.
Raccomandazioni di etica clinica per l’ammissione a trattamenti intensivi e per la loro sospensione, in condizioni eccezionali di squilibrio tra necessità e risorse disponibili. SIAARTI, Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva.
From the Italian Society of Anesthesia and Intensive Care comes a document which states: “It is a scenario in which the criteria for access to intensive care (and discharge) may be necessary, not only strictly according to clinical suitability and proportionality of care, but also inspired by such a shared criterion as that of distributive justice and adequate allocation of limited healthcare resources. Such a scenario can substantially resemble to the field of "disasters medicine". As an extension of the principle of proportionality of care, allocation in a context of severe health resources shortage should aim to provide intensive care for patients with a greater chance of therapeutic success: it is a matter of privileging the "greater life expectancy"”.
Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV. John L. Hick, Dan Hanfling, Matthew K. Wynia, and Andrew T. Pavia. National Academy of Medicine
An article that seeks to define how to plan crisis care standards, to make clinically informed decisions about scarce resource allocation during an epidemic, in an ethical and fair manner. This may include strategies such as preparing, preserving, replacing, adapting, reusing, and reallocating resources.
Consideracions deontològiques en relació a la pandèmia COVID-19. Comissions Deontològiques del Consell de Col·legis de Metges de Catalunya (CCMC)
The Council of Medical Colleges of Catalonia has set up a specific and permanent commission whose mission is to monitor the evolution of the health crisis generated by the COVID-19 pandemic from the point of view of medical deontology. The commission, which has just released its first communiqué, will go into more detail on those concrete issues that will be raised as this crisis progresses. The commission is comosed of members of the Deontology commissions of the four Catalan medical colleges (Barcelona, Girona, Lleida i Tarragona), as well as specialist doctors in different areas that are closely linked to patient care in this crisis.
COVID-19 Mental Health Impacts: Resources for Psychiatrists. American Psychatric Association.
The APA’s Committee on Psychiatric Dimensions of Disasters and the APA’s Council on International Psychiatry have compiled the following list of resources for psychiatrists. The resources cover not only the physical impact of the coronavirus, but also its mental health and its psychosocial problems and responses. A section on tools for telepsychiatry is also included, as well as preparation for the possibility of isolation and / or quarantine.
Enjeux éthiques face à une pandémie. Contribution du Comité Consultatif National d’Éthique pour les Sciences de la Vie et de la Santé
The French National Advisory Committee on Ethics for Life and Health Sciences has made ethical contributions with 10 ethical principles to take into account: 1. Citizen responsibility. 2. The political decision-making process based on the experience and contribution of civil society. 3. Binding measures must be based on legal procedure and solid ethics, and a pedagogy of decision-making. 4. Particular attention to precarious populations. 5. Transparent and responsible communication. 6. Remember confidentiality. 7. An international context to take into account. 8. Research with international effort. 9. Involvement of the pharmaceutical industry. 10. Guaranteeing healthcare.
And it points out 4 recommendations:
- The creation of a mixed body of scientific experts from different disciplines, including the humanities and social sciences, with members of civil society, able to take into account the opinion of different population categories.
- Ethical reflection about the care of serious patients and about the reorganization of healthcare services in the management of scarce resources (resuscitation beds, mechanical ventilation). It is proposed to establish an "ethical support unit" to support health professionals as closely as possible to define healthcare priorities.
- Encouraging innovation in solutions to be found in different areas, with the obligation to always refer to a shared ethical framework (policy for welcoming people; pooling in the organization of services; use of IT tools; consistency of taken decisions; consolidation of collective intelligence)-
- Rapid preparation of feedback and independent evaluation bringing together not only all the actors in the process of combating the epidemic (politicians; health professionals; scientists; citizens, etc.), but also taking an interest to the situation of the most precarious populations. The repetition of health crises highlighting the challenge of preparation between crises, encompassing health, organizational, social and ethical aspects, the information gathered during feedback will therefore prove essential.