Covid-19 — A Reminder to Reason

Zagury-Orly, Ivry; Schwartzstein, Richard M.

doi:10.1056/nejmp2009405

Cited by 106 publications

(92 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Zagury-Orly and Schwartzstein have recently argued that the health sector must accept that doctors' reasoning and decision-making are susceptible to human anxieties and in the "…effort to 'do good' for our patients, we may fall prey to cognitive biases and therapeutic errors". 10 We suggest the global publicity and panic regarding ICU triage distorted assessments of best interests and decision-making about admittance to ICU and slanted ethical debate. This has the potential to compromise important decisions with regard to care for patients with COVID-19.…”

Section: Current Controversymentioning

confidence: 95%

Revisiting the equity debate in COVID-19: ICU is no panacea

et al. 2020

View full text Add to dashboard Cite

Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit (ICU) resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuable but scarce resource in the pandemic context.In this paper, we argue that the concern about achieving equity in ICU triage is problematic for two reasons. First, ICU can be futile and prolong or exacerbate suffering rather than ameliorate it. This may be especially true in patients with COVID-19 with emerging data showing that most who receive access to a ventilator will still die. There is no value in admitting patients with poor prognostic indicators to ICU to meet an equity target when intensive critical care is contrary to their best interests. Second, the focus on ICU admission shifts focus away from important aspects of COVID-19 care where there is greater opportunity for mitigating suffering and enhancing equitable care.We propose that the focus on equity concerns during the pandemic should broaden to include providing all people who need it with access to the highest possible standard of end-of-life care. This requires attention to culturally safe care in the following interlinked areas: palliative care, communication and decision support and advanced care planning.

show abstract

Section: Current Controversymentioning

confidence: 95%

Revisiting the equity debate in COVID-19: ICU is no panacea

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Finalmente debemos impulsar la racionalidad y cautela en las múltiples intervenciones que se proponen en protocolos clínicos, manteniendo un escepticismo saludable e incertidumbre clínica ante la falta o los bajos niveles de evidencia. En especial debemos estar alertas frente a los sesgos de disponibilidad, el anclaje y el sesgo de confirmación 3 .…”

Section: Clinical Research In Covid-19 Eraunclassified

Investigación Clínica en tiempos de COVID-19

Mordojovich¹,

Cavada²,

Maturana³

et al. 2020

Rev. méd. Chile

View full text Add to dashboard Cite

“…Healthcare professionals are exposed to both traditional and social media and might not be immune to distrust and distorted risk perception 4. We are deeply concerned about the mental health effects of the covid-19 infodemic, especially among healthcare professionals, who are already overworked and exhausted 5.…”

mentioning

confidence: 99%