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Review
. 2022 Mar 15;11(6):1613.
doi: 10.3390/jcm11061613.

Ethical Lessons from an Intensivist's Perspective

Jean-Louis Vincent  1
Affiliations
Review

Ethical Lessons from an Intensivist's Perspective

Jean-Louis Vincent. J Clin Med. .

Abstract

Intensive care units (ICUs) around the world have been hugely impacted by the SARS-CoV-2 pandemic and the vast numbers of patients admitted with COVID-19, requiring respiratory support and prolonged stays. This pressure, with resulting shortages of ICU beds, equipment, and staff has raised ethical dilemmas as physicians have had to determine how best to allocate the sparse resources. Here, we reflect on some of the major ethical aspects of the COVID-19 pandemic, including resource allocation and rationing, end-of-life decision-making, and communication and staff support. Importantly, these issues are regularly faced in non-pandemic ICU patient management and useful lessons can be learned from the discussions that have occurred as a result of the COVID-19 situation.

Keywords: COVID-19; communication; distributive justice; intensive care; proportionality; rationing; withholding.

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Conflict of interest statement

The author declares no conflict of interest.

Figures

Figure 1
Figure 1
Two phases of reserving ICU beds for COVID-19 patients.
See this image and copyright information in PMC

References

    1. Kadri S.S., Sun J., Lawandi A., Strich J.R., Busch L.M., Keller M., Babiker A., Yek C., Malik S., Krack J., et al. Association between caseload surge and COVID-19 survival in 558 U.S. hospitals, March to August 2020. Ann. Intern. Med. 2021;174:1240–1251. doi: 10.7326/M21-1213. - DOI - PMC - PubMed
    1. Wahlster S., Sharma M., Lewis A.K., Patel P.V., Hartog C.S., Jannotta G., Blissitt P., Kross E.K., Kassebaum N.J., Greer D.M., et al. The Coronavirus Disease 2019 pandemic’s effect on critical care resources and health-care providers: A global survey. Chest. 2021;159:619–633. doi: 10.1016/j.chest.2020.09.070. - DOI - PMC - PubMed
    1. Al-Dorzi H.M., Aldawood A.S., Almatrood A., Burrows V., Naidu B., Alchin J.D., Alhumedi H., Tashkandi N., Al-Jahdali H., Hussain A., et al. Managing critical care during COVID-19 pandemic: The experience of an ICU of a tertiary care hospital. J. Infect. Public Health. 2021;14:1635–1641. doi: 10.1016/j.jiph.2021.09.018. - DOI - PMC - PubMed
    1. Lefrant J.Y., Fischer M.O., Potier H., Degryse C., Jaber S., Muller L., Pottecher J., Charboneau H., Meaudre E., Lanot P., et al. A national healthcare response to intensive care bed requirements during the COVID-19 outbreak in France. Anaesth. Crit. Care Pain Med. 2020;39:709–715. doi: 10.1016/j.accpm.2020.09.007. - DOI - PMC - PubMed
    1. Cai Y., Chen Y., Xiao L., Khor S., Liu T., Han Y., Yuan Y., Cai L., Zeng G., Wang X. The health and economic impact of constructing temporary field hospitals to meet the COVID-19 pandemic surge: Wuhan Leishenshan Hospital in China as a case study. J. Glob. Health. 2021;11:05023. doi: 10.7189/jogh.11.05023. - DOI - PMC - PubMed

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