Abstract
The catastrophic emergency experienced by many countries with the COVID-19 pandemic emphasized the importance of bioethics for decision-making, both at the public health (equitable and effective policies) and at the clinical level. At the clinical level, the issues are the fulfillment of medical care demand with adequate health care teams, infrastructure, and supplies, and to cover critical care demands that surpass the available resources. Therefore, ethically correct approaches are required for the allocation of life sustaining resources. There are recommendations for the allocating life support during disasters based on multiple considerations, including ethical ones. However, the ethical criteria of existing guidelines are variable. Ethical principles usually considered are saving the greatest number of lives, saving the greatest number of years of life and the principle of the life cycle or the goal to give each individual equal opportunity to live through the various phases of life. However, the centrality of the human being and the search for the common good should be considered. Knowledge of public perspectives and moral benchmarks on these issues is essential. A successful assignment effort will require everyone's trust and cooperation. Decision making should be planned and discussed in advance, since in-depth deliberation will be extremely complex during the disaster. Our goal is to help the health care teams to wisely allocate resources in shortage periods.
Highlights
The catastrophic emergency experienced by many countries with the COVID-19 pandemic emphasized the importance of bioethics for decision-making, both at the public health and at the clinical level
No se pretende dar respuestas concretas a todas las dudas éticas particulares que puedan surgir, pero sí lineamientos capaces de orientar y apoyar el juicio prudencial del equipo médico
Disponible en: https://www.samw.ch/ en/Ethics/Topics-A-to-Z/Intensive-care-medicine.html [Consultado el 24 de marzo de 2020]
Summary
Luca Valera[1,2], María Alejandra Carrasco[1,2], Rodrigo López[1,3], Paulina Ramos[1], Rommy von Bernhardi[1,4], Paula Bedregal[1,5], Alejandra Florenzano[1,6], Iván Pérez[1,6], Patricia Olivares[1,6], Ivonne Vargas[7], Ximena González[1,7], Paulo López[1,8], Gloria Durán[1], Constanza Richards[1], Ricardo Castro[1,9]. Ethical guidelines for medical decision-making during covid-19 pandemic in Chile. (Rev Med Chile 2020; 148: 393-398) Key words: Ethics, Clinical; Health Planning Guidelines; Resource Allocation. Las dudas éticas más punzantes se refieren principalmente a la asignación de los recursos en un contexto excepcional de “medicina de catástrofes” y, en consecuencia, a la admisión a la UCI y al manejo de los pacientes que cursan una enfermedad particularmente grave[4,5,6]. Este documento busca aportar una mirada ética –y no exclusivamente técnica– para esbozar un marco general que apoye a los equipos de salud en la toma de decisiones en estas condiciones excepcionales de gran desequilibrio entre las necesidades y los recursos disponibles.
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