The health emergency provoked by Coronavirus spreading, the high and exponentially growing number of people affected, the impact on people's lives and health care systems all over the world, the lack of personal protective equipment, ICU beds, medical staff, artificial respirators, etc. determined a scenario where social emergency led to an impact on the economy, fundamental rights, etc. There are some bioethical considerations in order to recommend decision-making on patient access to special care units in pandemic situations.
Bioethics and Law Observatory of U. Barcelona proposes some recommendations based on international human rights y bioethical principles such as respect, equity, transparency. Recommendations were done following a critical literature review of reports of different scientific organizations such as the Spanish Minister of Health, Hastings Center, Nuffield Council of Bioethics, NEJM, OMS, among others.
Two sets of recommendations: one regarding issues to consider beforehand (such as assessment of available resources, of the expected benefit for the individual patients, of clinical course, of the will of the patients and their families); and guidelines for action (among others: early and proactive assessment, comorbidity of patients, prioritisation of access to and use of these resources, the conformation of Hospital Triage Commitees, adequacy of end-of-life care and emotional support measures for professionals) should be done.
The context of triage determine some obligations: to organise contingency plans for health emergencies, equity measures for public health, caring for the privacy and confidentiality of patients, health providers, etc.; collegiate decision-making, assessing the ethical dilemmas of pandemics.
Given the health emergency conditions, this proposal is intended to guide the actions of professionals and facilitate homogeneous decision-making in the field of critical patient care.