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Tytuł pozycji:

Bin it or pin it? Which professional ethical guidance on managing COVID-19 should I follow?

Tytuł :
Bin it or pin it? Which professional ethical guidance on managing COVID-19 should I follow?
Autorzy :
Huxtable R; Centre for Ethics in Medicine, Population Health Sciences, Bristol Medical School, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .
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Źródło :
BMC medical ethics [BMC Med Ethics] 2020 Jul 15; Vol. 21 (1), pp. 60. Date of Electronic Publication: 2020 Jul 15.
Typ publikacji :
Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Original Publication: London : BioMed Central, [2000-
MeSH Terms :
Coronavirus Infections*
Ethics, Medical*
Pandemics*/ethics
Pneumonia, Viral*
Practice Guidelines as Topic*
Health Personnel/*ethics
Betacoronavirus ; Codes of Ethics ; Health Services Research ; Humans
References :
J Med Ethics. 2010 Sep;36(9):558-62. (PMID: 20817821)
Wellcome Open Res. 2018 Feb 22;3:15. (PMID: 29881785)
Nurs Ethics. 2019 May;26(3):646-662. (PMID: 28990446)
BMJ. 2020 May 21;369:m2033. (PMID: 32439751)
BMJ. 2014 Jan 29;348:g1106. (PMID: 24477009)
J Contin Educ Health Prof. 2002 Winter;22(1):3-10. (PMID: 12004638)
BMC Med Ethics. 2020 May 1;21(1):32. (PMID: 32357883)
Health Care Anal. 2013 Mar;21(1):54-69. (PMID: 23232923)
Clin Med (Lond). 2003 May-Jun;3(3):279-84. (PMID: 12848267)
Grant Information :
209841/Z/17/Z United Kingdom WT_ Wellcome Trust
Contributed Indexing :
Keywords: COVID-19*; Coronavirus*; Ethical guidance*; Professional guidance*
SCR Disease Name :
COVID-19
Entry Date(s) :
Date Created: 20200716 Date Completed: 20200727 Latest Revision: 20200727
Update Code :
20201023
PubMed Central ID :
PMC7360377
DOI :
10.1186/s12910-020-00491-5
PMID :
32664908
Czasopismo naukowe
Background: As the COVID-19 (coronavirus) pandemic develops, healthcare professionals are looking for support with, and guidance to inform, the difficult decisions they face. In the (current) absence of an authoritative national steer in England, professional bodies and local organisations have been developing and disseminating their own ethical guidance. Questions inevitably arise, some of which are particularly pressing during the pandemic, as events are unfolding quickly and the field is becoming crowded. My central question here is: which professional ethical guidance should the professional follow?
Main Body: Adopting a working definition of "professional ethical guidance", I offer three domains for a healthcare professional to consider, and some associated questions to ask, when determining whether - in relation to any guidance document - they should "bin it or pin it". First, the professional should consider the source of the guidance: is the issuing body authoritative or, if not, at least sufficiently influential that its guidance should be followed? Second, the professional should consider the applicability of the guidance, ascertaining whether the guidance is available and, if so, whether it is pertinent. Pertinence has various dimensions, including whether the guidance applies to this professional, this patient and/or this setting, whether it is up-to-date, and whether the guidance addresses the situation the professional is facing. Third, the professional should consider the methodology and methods by which the guidance was produced. Although the substantive quality of the guidance is important, so too are the methods by which it was produced. Here, the professional should ask whether the guidance is sufficiently inclusive - in terms of who has prepared it and who contributed to its development - and whether it was rigorously developed, and thus utilised appropriate processes, principles and evidence.
Conclusion: Asking and answering such questions may be challenging, particularly during a pandemic. Furthermore, guidance will not do all the work: professionals will still need to exercise their judgment in deciding what is best in the individual case, whether or not this concerns COVID-19. But such judgments can and should be informed (and constrained) by guidance, and hopefully these preliminary observations will provide some useful pointers for time-pressed professionals.

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