RESUMO
The treatment of patients with cancer who test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses unique challenges. In this commentary, the authors describe the ethical rationale and implementation details for the creation of a novel, multidisciplinary treatment prioritization committee, including physicians, frontline staff, an ethicist, and an infectious disease expert. Organizational obligations to health care workers also are discussed. The treatment prioritization committee sets a threshold of acceptable harm to patients from decreased cancer control that is justified to reduce risk to staff. The creation of an ethical, consistent, and transparent decision-making process involving such frontline stakeholders is essential as departments across the country are faced with decisions regarding the treatment of SARS-CoV-2-positive patients with cancer.
Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Atenção à Saúde/ética , Pessoal de Saúde/ética , Neoplasias/complicações , Pandemias/ética , Pneumonia Viral/complicações , Qualidade da Assistência à Saúde/ética , Assistência Ambulatorial/ética , Assistência Ambulatorial/organização & administração , COVID-19 , Tomada de Decisão Clínica , Infecções por Coronavirus/virologia , Atenção à Saúde/organização & administração , Pessoal de Saúde/organização & administração , Humanos , Neoplasias/radioterapia , Segurança do Paciente , Pneumonia Viral/virologia , Qualidade da Assistência à Saúde/organização & administração , SARS-CoV-2RESUMO
OBJECTIVE AND METHOD: To consider the possibility that adverse aspects of psychiatric hospitalisation may precipitate suicide contributing significantly to the increased rate of suicide among inpatients, given little has been published about this. RESULTS AND CONCLUSIONS: It is likely that psychiatric hospitalisation itself contributes to some inpatient suicides. This has significant implications for the delivery of inpatient psychiatric care.