Etiske dilemmaer i sykehusene under covid-19-pandemien

Larsen, Berit Hofset; Magelssen, Morten; Dunlop, Oona; Pedersen, Reidar; Før­de, Rei­dun

doi:10.4045/tidsskr.20.0851

Cited by 6 publications

(5 citation statements)

References 1 publication

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“…Sykehjemslegene opplevde i starten av pandemien at de ofte stod alene med ansvaret for beboerne og at beboere med behov for utredning ble nedprioritert for å sikre kapasiteten på sykehusene. I en studie av etiske dilemmaer ved norske sykehus under pandemien konkluderte man med at helsetilbudet til eldre trolig ikke var godt nok i starten av pandemien (12). Andre har også kritisert prioriteringsretningslinjene for å indirekte føre til aldersdiskriminering, som igjen førte til uforholdsmessig lav innleggelse av sykehjemsbeboere under pandemien i Norge (13,14).…”

Section: H Vo R Da N F O R D E L E R E S S U R S E R R E T T F E R D ...unclassified

Ethical dilemmas for nursing home doctors during the COVID-19 pandemic

McLean¹,

Onarheim²,

Schanche³

et al. 2022

Tidsskriftet

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Bergen senter for etikk og prioritering (BCEPS) Institu for global helse og samfunnsmedisin Universitetet i Bergen Forfa erbidrag: utforming av idé, utforming av studien, datainnsamling, analyse av datamaterialet, li eratursøk, hovedansvar for utarbeiding og revisjon av manus og godkjenning av innsendte manusversjon. Emily McLean er lege og stipendiat. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Bergen senter for etikk og prioritering (BCEPS) Institu for global helse og samfunnsmedisin Universitetet i Bergen Forfa erbidrag: utforming av idé, utforming av studien, li eratursøk, utarbeiding og revisjon av manus og godkjenning av innsendte manusversjon. Kristine Husøy Onarheim er ph.d., lege og tilkny et forsker. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Institu for klinisk psykologi Universitetet i BergenForfa erbidrag: utforming av idé, li eratursøk, utarbeiding og revisjon av manus, godkjenning av innsendte manusversjon. Elisabeth Schanche er professor i klinisk psykologi. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. LungeavdelingaHaukeland universitetssjukehus og Klinisk institu 1 Universitetet i Bergen Forfa erbidrag: li eratursøk, utarbeiding og revisjon av manus og godkjenning av innsendte manusversjon. Margrethe Aase Schaufel er spesialist i lunge-og hjertesykdommer, overlege og førsteamanuensis. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.

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Section: H Vo R Da N F O R D E L E R E S S U R S E R R E T T F E R D ...unclassified

Ethical dilemmas for nursing home doctors during the COVID-19 pandemic

McLean¹,

Onarheim²,

Schanche³

et al. 2022

Tidsskriftet

View full text Add to dashboard Cite

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“…However, the specialists considered telehealth as an inappropriate tool for follow-up appointments due to the need for physical examinations, reflecting a sole focus on patients' physical health needs. Moreover, during the first year of the pandemic, when data were collected, it is likely that the hospital management prioritized resources for emergency care and hospitalized patients [22].…”

Section: Discussionmentioning

confidence: 99%

Patient Experiences after Physical Trauma: The Negative Effect of the COVID-19 Pandemic on Recovery

Finstad

Clausen

Rosseland

et al. 2022

IJERPH

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The coronavirus disease 2019 (COVID-19) pandemic generated a crisis within the healthcare system, during which acute, COVID-19-related health needs were prioritized over less urgent needs, including vulnerable subgroups. This study explored experiences of recovery among survivors of physical injuries associated with severe pain during the COVID-19 pandemic in Norway. In-depth interviews were conducted among 13 participants. Findings generated by a thematic analysis revealed that the pandemic, including the contagion control measures and interrupted healthcare, were of negative consequence for the participants’ recovery experiences and mental and physical health. Despite experiencing severe pain and perceived needs for support, the participants experienced being deprioritized by the healthcare system. They experienced a reduced capacity to cope with pandemic-related stress and to perform everyday tasks, which they perceived as generating an additional burden for their loved ones. Alcohol was reported to be used in an effort to relieve the associated mental distress. As suggested by this study, injury survivors constitute a vulnerable subgroup for whom the continuity of rehabilitation services during a national crisis, as well as the integration of mental health support, can be essential for mitigating the negative impact of the crisis on recovery and for promoting optimal long-term health outcomes.

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“…We saw no difference between hospital doctors and GPs regarding the experience of deprioritization, while more GPs considered the priorities to be medically indefensible. A possible reason for this may be that the GPs were closer to the nursing homes, where the mortality rates were the highest [19].…”

Section: Medically Indefensible Prioritiesmentioning

confidence: 99%

Guidelines and clinical priority setting during the COVID-19 pandemic – Norwegian doctors’ experiences

Bringedal

Rø

Bååthe

et al. 2022

BMC Health Serv Res

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Background In the first phase of the COVID-19 pandemic, strong measures were taken to avoid anticipated pressure on health care, and this involved new priorities between patient groups and changing working conditions for clinical personnel. We studied how doctors experienced this situation. Our focus was their knowledge about and adherence to general and COVID-19 specific guidelines and regulations on priority setting, and whether actual priorities were considered acceptable. Methods In December 2020, 2 316 members of a representative panel of doctors practicing in Norway received a questionnaire. The questions were designed to consider a set of hypotheses about priority setting and guidelines. The focus was on the period between March and December 2020. Responses were analyzed with descriptive statistics and regression analyses. Results In total, 1 617 (70%) responded. A majority were familiar with the priority criteria, though not the legislation on priority setting. A majority had not used guidelines for priority setting in the first period of the pandemic. 60.5% reported that some of their patients were deprioritized for treatment. Of these, 47.5% considered it medically indefensible to some/a large extent. Although general practitioners (GPs) and hospital doctors experienced deprioritizations equally often, more GPs considered it medically indefensible. More doctors in managerial positions were familiar with the guidelines. Conclusions Most doctors did not use priority guidelines in this period. They experienced, however, that some of their patients were deprioritized, which was considered medically indefensible by many. This might be explained by a negative reaction to the externally imposed requirements for rationing, while observing that vulnerable patients were deprioritized. Another interpretation is that they judged the rationing to have gone too far, or that they found it hard to accept rationing of care in general. Priority guidelines can be useful measures for securing fair and reasonable priorities. However, if the priority setting in clinical practice is to proceed in accordance with priority-setting principles and guidelines, the guidelines must be translated into a clinically relevant context and doctors’ familiarity with them must improve.

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Etiske dilemmaer i sykehusene under covid-19-pandemien

Cited by 6 publications

References 1 publication

Ethical dilemmas for nursing home doctors during the COVID-19 pandemic

Ethical dilemmas for nursing home doctors during the COVID-19 pandemic

Patient Experiences after Physical Trauma: The Negative Effect of the COVID-19 Pandemic on Recovery

Guidelines and clinical priority setting during the COVID-19 pandemic – Norwegian doctors’ experiences

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