Ethical decisions in the allocation of scarce resources in intensive care units during the pandemic
Keywords:
RESOURCE ALLOCATION, COVID-19, ETHICS, DECISION MAKING, INTENSIVE CARE UNITS.Abstract
Rationale: during the first months of the 2019 coronavirus pandemic, many healthcare centers and systems were overwhelmed by the number of patients and the need to provide the resources needed to care for them.
Objective: to analyze the ethical decisions in the allocation of scarce resources in the intensive care unit in an Ecuadorian hospital during the COVID-19 pandemic.
Method: a qualitative, cross-sectional and descriptive study was carried out with 20 health professionals who worked in the ICU. An interview guide with 5 questions was used, with an open-ended answer option on the ethical criteria for decision- making in the face of scarce resources and data analysis was carried out using ATLAS.Ti. software.
Results: the categories addressed were justice, charity, biosafety, workload and resource scarcity. In the responses of health professionals, it was observed that ethics was an important factor in allocating scarce resources to address emerging diseases such as COVID-19 where justice was visualized as a relevant ethical behaviour in the ICU. In addition, they emphasized the maximization of benefits to patients regardless of resource scarcity.
Conclusions: the allocation of limited resources and changes in clinical practices during health emergencies may be unknown to some health professionals. However, the principles of justice and charity were essential for rationing decisions during the COVID-19 pandemic at the ICU.
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