Ethical triage during the COVID-19 pandemic: a toolkit for neurosurgical resource allocation

被引：27
|
作者：
Hulsbergen, Alexander F. C. [1 ,2 ,3 ]
Eijkholt, Marleen M. [1 ,4 ]
Balak, Naci [1 ]
Brennum, Jannick [1 ]
Bolger, Ciaran [1 ,5 ]
Bohrer, Anna-Margarete [1 ]
Feldman, Zeev [1 ]
Holsgrove, Daniel [1 ]
Kitchen, Neil [1 ]
Mathiesen, Tiit I. [1 ,6 ,7 ,8 ]
Moojen, Wouter A. [1 ,2 ,3 ]
Sampron, Nicolas [1 ,9 ]
Sames, Martin [1 ]
Sandvik, Ulrika [1 ,8 ]
Tisell, Magnus [1 ]
Broekman, Marike L. D. [1 ,2 ,3 ]
机构：
[1] European Assoc Neurosurg Soc, Eth Comm, Brussels, Belgium
[2] Haaglanden Med Ctr, Dept Neurosurg, Lijnbaan 32, NL-2512 VA The Hague, Netherlands
[3] Leiden Univ, Med Ctr, Lijnbaan 32, NL-2512 VA The Hague, Netherlands
[4] Leiden Univ, Unit Eth & Hlth Care, Lijnbaan 32, NL-2512 VA The Hague, Netherlands
[5] Beaumont Hosp, Dept Clin Neurosci, Dublin, Ireland
[6] Copenhagen Univ Hosp, Rigshosp, Dept Neurosurg, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
[7] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark
[8] Karolinska Intitutet, Sect Neurosurg, Dept Clin Neurosci, Stockholm, Sweden
[9] Hosp Univ Donostia, Dept Neurosurg, San Sebastian, Spain
来源：
ACTA NEUROCHIRURGICA | 2020年 / 162卷 / 07期
关键词：
Covid-19; Ethics; Triage; Neurosurgery; SARS-CoV-2;
D O I：
10.1007/s00701-020-04375-w
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Background The COVID-19 pandemic confronts healthcare workers, including neurosurgeons, with difficult choices regarding which patients to treat. Methods In order to assist ethical triage, this article gives an overview of the main considerations and ethical principles relevant when allocating resources in times of scarcity. Results We discuss a framework employing four principles: prioritizing the worst off, maximizing benefits, treating patients equally, and promoting instrumental value. We furthermore discuss the role of age and comorbidity in triage and highlight some principles that may seem intuitive but should not form a basis for triage. Conclusions This overview is presented on behalf of the European Association of Neurosurgical Societies and can be used as a toolkit for neurosurgeons faced with ethical dilemmas when triaging patients in times of scarcity.
引用
收藏
页码：1485 / 1490
页数：6
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