Ethical dilemmas due to the Covid-19 pandemic.
Identifieur interne : 001015 ( Main/Exploration ); précédent : 001014; suivant : 001016Ethical dilemmas due to the Covid-19 pandemic.
Auteurs : René Robert [France] ; Nancy Kentish-Barnes [France] ; Alexandre Boyer [France] ; Alexandra Laurent [France] ; Elie Azoulay [France] ; Jean Reignier [France]Source :
- Annals of intensive care [ 2110-5820 ] ; 2020.
Abstract
The devastating pandemic that has stricken the worldwide population induced an unprecedented influx of patients in ICUs, raising ethical concerns not only surrounding triage and withdrawal of life support decisions, but also regarding family visits and quality of end-of-life support. These ingredients are liable to shake up our ethical principles, sharpen our ethical dilemmas, and lead to situations of major caregiver sufferings. Proposals have been made to rationalize triage policies in conjunction with ethical justifications. However, whatever the angle of approach, imbalance between utilitarian and individual ethics leads to unsolvable discomforts that caregivers will need to overcome. With this in mind, we aimed to point out some critical ethical choices with which ICU caregivers have been confronted during the Covid-19 pandemic and to underline their limits. The formalized strategies integrating the relevant tools of ethical reflection were disseminated without deviating from usual practices, leaving to intensivists the ultimate choice of decision.
DOI: 10.1186/s13613-020-00702-7
PubMed: 32556826
PubMed Central: PMC7298921
Affiliations:
- France
- Aquitaine, Bourgogne, Bourgogne-Franche-Comté, Nouvelle-Aquitaine, Pays de la Loire, Poitou-Charentes, Île-de-France
- Bordeaux, Dijon, Nantes, Paris, Poitiers
- Université de Bordeaux, Université de Nantes, Université de Poitiers
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Réanimation Chirurgicale, Dijon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Chirurgicale, Dijon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Bourgogne</region><settlement type="city">Dijon</settlement></placeName></affiliation></author><author><name sortKey="Azoulay, Elie" sort="Azoulay, Elie" uniqKey="Azoulay E" first="Elie" last="Azoulay">Elie Azoulay</name><affiliation wicri:level="3"><nlm:affiliation>Service de Réanimation Médicale, APHP, CHU Saint-Louis, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, APHP, CHU Saint-Louis, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Groupe de Recherche Famiréa, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Groupe de Recherche Famiréa, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Reignier, Jean" sort="Reignier, Jean" uniqKey="Reignier J" first="Jean" last="Reignier">Jean Reignier</name><affiliation wicri:level="4"><nlm:affiliation>Université de Nantes, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université de Nantes, Nantes</wicri:regionArea><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName><orgName type="university">Université de Nantes</orgName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes</wicri:regionArea><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author></analytic><series><title level="j">Annals of intensive care</title><idno type="ISSN">2110-5820</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The devastating pandemic that has stricken the worldwide population induced an unprecedented influx of patients in ICUs, raising ethical concerns not only surrounding triage and withdrawal of life support decisions, but also regarding family visits and quality of end-of-life support. These ingredients are liable to shake up our ethical principles, sharpen our ethical dilemmas, and lead to situations of major caregiver sufferings. Proposals have been made to rationalize triage policies in conjunction with ethical justifications. However, whatever the angle of approach, imbalance between utilitarian and individual ethics leads to unsolvable discomforts that caregivers will need to overcome. With this in mind, we aimed to point out some critical ethical choices with which ICU caregivers have been confronted during the Covid-19 pandemic and to underline their limits. The formalized strategies integrating the relevant tools of ethical reflection were disseminated without deviating from usual practices, leaving to intensivists the ultimate choice of decision.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32556826</PMID><DateRevised><Year>2020</Year><Month>06</Month><Day>22</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Print">2110-5820</ISSN><JournalIssue CitedMedium="Print"><Volume>10</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>Jun</Month><Day>17</Day></PubDate></JournalIssue><Title>Annals of intensive care</Title><ISOAbbreviation>Ann Intensive Care</ISOAbbreviation></Journal><ArticleTitle>Ethical dilemmas due to the Covid-19 pandemic.</ArticleTitle><Pagination><MedlinePgn>84</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13613-020-00702-7</ELocationID><Abstract><AbstractText>The devastating pandemic that has stricken the worldwide population induced an unprecedented influx of patients in ICUs, raising ethical concerns not only surrounding triage and withdrawal of life support decisions, but also regarding family visits and quality of end-of-life support. These ingredients are liable to shake up our ethical principles, sharpen our ethical dilemmas, and lead to situations of major caregiver sufferings. Proposals have been made to rationalize triage policies in conjunction with ethical justifications. However, whatever the angle of approach, imbalance between utilitarian and individual ethics leads to unsolvable discomforts that caregivers will need to overcome. With this in mind, we aimed to point out some critical ethical choices with which ICU caregivers have been confronted during the Covid-19 pandemic and to underline their limits. The formalized strategies integrating the relevant tools of ethical reflection were disseminated without deviating from usual practices, leaving to intensivists the ultimate choice of decision.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Robert</LastName><ForeName>René</ForeName><Initials>R</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-5989-5409</Identifier><AffiliationInfo><Affiliation>Université de Poitiers, Poitiers, France. rene.robert@chu-poitiers.fr.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Inserm CIC 1402, Axe Alive, Poitiers, France. rene.robert@chu-poitiers.fr.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, CHU Poitiers, Poitiers, France. rene.robert@chu-poitiers.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kentish-Barnes</LastName><ForeName>Nancy</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Service de Réanimation Médicale, APHP, CHU Saint-Louis, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Groupe de Recherche Famiréa, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boyer</LastName><ForeName>Alexandre</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Université de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, CHU Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Laurent</LastName><ForeName>Alexandra</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Laboratoire psy-DREPI, Université de Bourgogne Franche-Comté, 7458, Dijon, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Service de Réanimation Chirurgicale, Dijon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Azoulay</LastName><ForeName>Elie</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Service de Réanimation Médicale, APHP, CHU Saint-Louis, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Groupe de Recherche Famiréa, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Reignier</LastName><ForeName>Jean</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Université de Nantes, Nantes, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Ann Intensive Care</MedlineTA><NlmUniqueID>101562873</NlmUniqueID><ISSNLinking>2110-5820</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Burnout</Keyword><Keyword MajorTopicYN="N">Covid-19</Keyword><Keyword MajorTopicYN="N">End-of-life</Keyword><Keyword MajorTopicYN="N">Ethics</Keyword><Keyword MajorTopicYN="N">Family-centered care</Keyword><Keyword MajorTopicYN="N">ICU</Keyword><Keyword MajorTopicYN="N">Pandemic</Keyword><Keyword MajorTopicYN="N">Triage</Keyword><Keyword MajorTopicYN="N">Withdrawal of life support</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>06</Month><Day>11</Day></PubMedPubDate><PubMedPubDate 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sortKey="Robert, Rene" sort="Robert, Rene" uniqKey="Robert R" first="René" last="Robert">René Robert</name></region><name sortKey="Azoulay, Elie" sort="Azoulay, Elie" uniqKey="Azoulay E" first="Elie" last="Azoulay">Elie Azoulay</name><name sortKey="Azoulay, Elie" sort="Azoulay, Elie" uniqKey="Azoulay E" first="Elie" last="Azoulay">Elie Azoulay</name><name sortKey="Boyer, Alexandre" sort="Boyer, Alexandre" uniqKey="Boyer A" first="Alexandre" last="Boyer">Alexandre Boyer</name><name sortKey="Boyer, Alexandre" sort="Boyer, Alexandre" uniqKey="Boyer A" first="Alexandre" last="Boyer">Alexandre Boyer</name><name sortKey="Kentish Barnes, Nancy" sort="Kentish Barnes, Nancy" uniqKey="Kentish Barnes N" first="Nancy" last="Kentish-Barnes">Nancy Kentish-Barnes</name><name sortKey="Kentish Barnes, Nancy" sort="Kentish Barnes, Nancy" uniqKey="Kentish Barnes N" first="Nancy" last="Kentish-Barnes">Nancy Kentish-Barnes</name><name sortKey="Laurent, Alexandra" sort="Laurent, Alexandra" uniqKey="Laurent A" first="Alexandra" last="Laurent">Alexandra Laurent</name><name sortKey="Laurent, Alexandra" sort="Laurent, Alexandra" uniqKey="Laurent A" first="Alexandra" last="Laurent">Alexandra Laurent</name><name sortKey="Reignier, Jean" sort="Reignier, Jean" uniqKey="Reignier J" first="Jean" last="Reignier">Jean Reignier</name><name sortKey="Reignier, Jean" sort="Reignier, Jean" uniqKey="Reignier J" first="Jean" last="Reignier">Jean Reignier</name><name sortKey="Robert, Rene" sort="Robert, Rene" uniqKey="Robert R" first="René" last="Robert">René Robert</name><name sortKey="Robert, Rene" sort="Robert, Rene" uniqKey="Robert R" first="René" last="Robert">René Robert</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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