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Review
. 2020 Nov;75(11):1517-1528.
doi: 10.1111/anae.15147. Epub 2020 Jun 11.

COVID-19: legal implications for critical care

N Coghlan  1   2 , D Archard  3 , P Sipanoun  4 , T Hayes  5 , B Baharlo  6
Affiliations
Review

COVID-19: legal implications for critical care

N Coghlan et al. Anaesthesia. 2020 Nov.

Abstract

The COVID-19 pandemic has caused an unprecedented challenge for the provision of critical care. Anticipating an unsustainable burden on the health service, the UK Government introduced numerous legislative measures culminating in the Coronavirus Act, which interfere with existing legislation and rights. However, the existing standards and legal frameworks relevant to critical care clinicians are not extinguished, but anticipated to adapt to a new context. This new context influences the standard of care that can be reasonably provided and yields many human rights considerations, for example, in the use of restraints, or the restrictions placed on patients and visitors under the Infection Prevention and Control guidance. The changing landscape has also highlighted previously unrecognised legal dilemmas. The perceived difficulties in the provision of personal protective equipment for employees pose a legal risk for Trusts and a regulatory risk for clinicians. The spectre of rationing critical care poses a number of legal issues. Notably, the flux between clinical decisions based on best interests towards decisions explicitly based on resource considerations should be underpinned by an authoritative public policy decision to preserve legitimacy and lawfulness. Such a policy should be medically coherent, legally robust and ethically justified. The current crisis poses numerous challenges for clinicians aspiring to remain faithful to medicolegal and human rights principles developed over many decades, especially when such principles could easily be dismissed. However, it is exactly at such times that these principles are needed the most and clinicians play a disproportionate role in safeguarding them for the most vulnerable.

Keywords: COVID-19; critical care; human rights; law; resource allocation.

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Figures

Figure 1
Figure 1
Considerations for the lawful use of physical or mechanical restraints in critical care.
Figure 2
Figure 2
Video calls between ICU patients and their family: data protection issues. GDPR, General Data Protection Regulation; MCA, Mental Capacity Act [54, 55].
Figure 3
Figure 3
Judicial review and rationing decisions [76].
See this image and copyright information in PMC

Comment in

References

    1. World Health Organization . Disease outbreak news: pneumonia of unknown cause – China. 2020. https://www.who.int/csr/don/05‐january‐2020‐pneumonia‐of‐unkown‐cause‐ch... (accessed 16/04/2020).
    1. World Health Organization . Novel coronavirus – China. 2020. https://www.who.int/csr/don/12‐january‐2020‐novel‐coronavirus‐china/en/ (accessed 16/04/2020).
    1. Viruses, Coronaviridae Study Group of the International Committee on Taxonomy of Viruses, ‘Consensus statement’ . The species severe acute respiratory syndrome related coronavirus: classifying 2019‐nCoV and naming it SARS‐Cov‐2. Nature Microbiology 2020; 5: 536–44. - PMC - PubMed
    1. World Health Organization . Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019‐nCoV). 2020. https://www.who.int/news‐room/detail/30‐01‐2020‐statement‐on‐the‐second‐... (accessed 16/04/2020).
    1. World Health Organization . WHO Director‐General's opening remarks at the media briefing on COVID‐19. 2020. https://www.who.int/dg/speeches/detail/who‐director‐general‐s‐opening‐re... (accessed 17/04/2020).