Caring for Frail Older Adults DuringCOVID-19: Integrating Public Health Ethics into Clinical Practice
Caring for Frail Older Adults DuringCOVID-19: Integrating Public Health Ethics into Clinical Practice
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DOI：
10.1111/jgs.16666
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发表时间：
2020-07-04
影响因子：
6.3
通讯作者：
Chase, Jocelyn
中科院分区：
文献类型：
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作者：
Chase, Jocelyn
在 2019 年冠状病毒病 (COVID-19) 大流行期间，临床和公共卫生伦理原则提示临床医生和医疗保健管理人员为倾向于避免重症监护的体弱老年人以及因危机分类而无法获得重症监护时制定替代方案。本文将探讨加拿大不列颠哥伦比亚省 (BC) 发布的 COVID-19 道德决策框架，以使临床医生和政策制定者熟悉道德原则如何指导系统变革，为体弱的老年人服务。在不列颠哥伦比亚省，医疗保健系统已启动资源来支持临床医生进行积极的预先护理计划讨论，并为长期护理机构的居民提供增强的支持性和姑息性护理选择。如果大流行确实压垮了医疗保健系统，那么虚弱（而不仅仅是年龄）可以提供一种公平且基于证据的方法来对重症监护患者进行分流，并且可以纳入呼吸机分配框架。
During the coronavirus disease 2019 (COVID-19) pandemic, principles from both clinical and public health ethics cue clinicians and healthcare administrators to plan alternatives for frail older adults who prefer to avoid critical care, and for when critical care is not available due to crisis triaging. This article will explore the COVID-19 Ethical Decision Making Framework, published in British Columbia (BC), Canada, to familiarize clinicians and policy makers with how ethical principles can guide systems change, in the service of frail older adults. In BC, the healthcare system has launched resources to support clinicians in proactive advance care planning discussions, and is providing enhanced supportive and palliative care options to residents of long-term care facilities. If the pandemic truly overwhelms the healthcare system, frailty, but not age alone, provides a fair and evidence-based means of triaging patients for critical care and could be included into ventilator allocation frameworks.