Crisis standards of care in a pandemic: navigating the ethical, clinical, psychological and policy-making maelstrom

Author:

Hertelendy Attila J12ORCID,Ciottone Gregory R2,Mitchell Cheryl L3,Gutberg Jennifer4,Burkle Frederick M5

Affiliation:

1. Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, 33199, USA

2. Beth Israel Deaconess Medical Center, Disaster Medicine Fellowship Program, Boston, MA, 02215, USA

3. Faculty & MBA Academic Director, Gustavson School of Business, University of Victoria, Victoria, British Columbia, V8W 2Y2, Canada

4. PhD Candidate, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, M5T 3M6, Canada

5. Senior Fellow and Scientist, Harvard Humanitarian Initiative, Harvard University and T.H. Chan School of Public Health, Cambridge, MA, 02115, USA

Abstract

Abstract The COVID-19 pandemic has caused clinicians at the frontlines to confront difficult decisions regarding resource allocation, treatment options and ultimately the life-saving measures that must be taken at the point of care. This article addresses the importance of enacting crisis standards of care (CSC) as a policy mechanism to facilitate the shift to population-based medicine. In times of emergencies and crises such as this pandemic, the enactment of CSC enables concrete decisions to be made by governments relating to supply chains, resource allocation and provision of care to maximize societal benefit. This shift from an individual to a population-based societal focus has profound consequences on how clinical decisions are made at the point of care. Failing to enact CSC may have psychological impacts for healthcare providers particularly related to moral distress, through an inability to fully enact individual beliefs (individually focused clinical decisions) which form their moral compass.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,Health Policy,General Medicine

Reference32 articles.

1. 50 states or 50 countries: what did we miss and what do we do now?;Burkle;Prehosp Disaster Med,2020

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