Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.
Identifieur interne : 000438 ( Main/Exploration ); précédent : 000437; suivant : 000439Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.
Auteurs : Diego S. Silva [Canada] ; Jennifer L. Gibson ; Ann Robertson ; Cécile M. Bensimon ; Sachin Sahni ; Laena Maunula ; Maxwell J. SmithSource :
- BMC public health [ 1471-2458 ] ; 2012.
Descripteurs français
- KwdFr :
- MESH :
- thérapie : Grippe humaine.
- épidémiologie : Grippe humaine.
- Canada, Humains, Pandémies, Ressources en santé, Unités de soins intensifs.
- Wicri :
- geographic : Canada.
English descriptors
- KwdEn :
- MESH :
- geographic : Canada.
- epidemiology : Influenza, Human.
- therapy : Influenza, Human.
- Health Resources, Humans, Intensive Care Units, Pandemics.
Abstract
BACKGROUND
Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources.
METHODS
To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis.
RESULTS
Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues.
CONCLUSIONS
Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.
DOI: 10.1186/1471-2458-12-241
PubMed: 22449119
PubMed Central: PMC3331804
Affiliations:
Links toward previous steps (curation, corpus...)
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Silva</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health and Joint Centre for Bioethics, University of Toronto, 155 College Street, Suite 754, Toronto, ON M5T 1P8, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health and Joint Centre for Bioethics, University of Toronto, 155 College Street, Suite 754, Toronto, ON M5T 1P8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Gibson, Jennifer L" sort="Gibson, Jennifer L" uniqKey="Gibson J" first="Jennifer L" last="Gibson">Jennifer L. Gibson</name></author><author><name sortKey="Robertson, Ann" sort="Robertson, Ann" uniqKey="Robertson A" first="Ann" last="Robertson">Ann Robertson</name></author><author><name sortKey="Bensimon, Cecile M" sort="Bensimon, Cecile M" uniqKey="Bensimon C" first="Cécile M" last="Bensimon">Cécile M. Bensimon</name></author><author><name sortKey="Sahni, Sachin" sort="Sahni, Sachin" uniqKey="Sahni S" first="Sachin" last="Sahni">Sachin Sahni</name></author><author><name sortKey="Maunula, Laena" sort="Maunula, Laena" uniqKey="Maunula L" first="Laena" last="Maunula">Laena Maunula</name></author><author><name sortKey="Smith, Maxwell J" sort="Smith, Maxwell J" uniqKey="Smith M" first="Maxwell J" last="Smith">Maxwell J. 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Silva</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health and Joint Centre for Bioethics, University of Toronto, 155 College Street, Suite 754, Toronto, ON M5T 1P8, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health and Joint Centre for Bioethics, University of Toronto, 155 College Street, Suite 754, Toronto, ON M5T 1P8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Gibson, Jennifer L" sort="Gibson, Jennifer L" uniqKey="Gibson J" first="Jennifer L" last="Gibson">Jennifer L. Gibson</name></author><author><name sortKey="Robertson, Ann" sort="Robertson, Ann" uniqKey="Robertson A" first="Ann" last="Robertson">Ann Robertson</name></author><author><name sortKey="Bensimon, Cecile M" sort="Bensimon, Cecile M" uniqKey="Bensimon C" first="Cécile M" last="Bensimon">Cécile M. Bensimon</name></author><author><name sortKey="Sahni, Sachin" sort="Sahni, Sachin" uniqKey="Sahni S" first="Sachin" last="Sahni">Sachin Sahni</name></author><author><name sortKey="Maunula, Laena" sort="Maunula, Laena" uniqKey="Maunula L" first="Laena" last="Maunula">Laena Maunula</name></author><author><name sortKey="Smith, Maxwell J" sort="Smith, Maxwell J" uniqKey="Smith M" first="Maxwell J" last="Smith">Maxwell J. Smith</name></author></analytic><series><title level="j">BMC public health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Canada (MeSH)</term><term>Health Resources (MeSH)</term><term>Humans (MeSH)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (therapy)</term><term>Intensive Care Units (MeSH)</term><term>Pandemics (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Canada (MeSH)</term><term>Grippe humaine (thérapie)</term><term>Grippe humaine (épidémiologie)</term><term>Humains (MeSH)</term><term>Pandémies (MeSH)</term><term>Ressources en santé (MeSH)</term><term>Unités de soins intensifs (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Canada</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Health Resources</term><term>Humans</term><term>Intensive Care Units</term><term>Pandemics</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Canada</term><term>Humains</term><term>Pandémies</term><term>Ressources en santé</term><term>Unités de soins intensifs</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Canada</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22449119</PMID><DateCompleted><Year>2012</Year><Month>08</Month><Day>27</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2458</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><PubDate><Year>2012</Year><Month>Mar</Month><Day>26</Day></PubDate></JournalIssue><Title>BMC public health</Title><ISOAbbreviation>BMC Public Health</ISOAbbreviation></Journal><ArticleTitle>Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.</ArticleTitle><Pagination><MedlinePgn>241</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2458-12-241</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. 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ValidYN="Y"><LastName>Maunula</LastName><ForeName>Laena</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Maxwell J</ForeName><Initials>MJ</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>03</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Public Health</MedlineTA><NlmUniqueID>100968562</NlmUniqueID><ISSNLinking>1471-2458</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002170" MajorTopicYN="N" Type="Geographic">Canada</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006295" MajorTopicYN="Y">Health 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Bensimon</name><name sortKey="Gibson, Jennifer L" sort="Gibson, Jennifer L" uniqKey="Gibson J" first="Jennifer L" last="Gibson">Jennifer L. Gibson</name><name sortKey="Maunula, Laena" sort="Maunula, Laena" uniqKey="Maunula L" first="Laena" last="Maunula">Laena Maunula</name><name sortKey="Robertson, Ann" sort="Robertson, Ann" uniqKey="Robertson A" first="Ann" last="Robertson">Ann Robertson</name><name sortKey="Sahni, Sachin" sort="Sahni, Sachin" uniqKey="Sahni S" first="Sachin" last="Sahni">Sachin Sahni</name><name sortKey="Smith, Maxwell J" sort="Smith, Maxwell J" uniqKey="Smith M" first="Maxwell J" last="Smith">Maxwell J. Smith</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Silva, Diego S" sort="Silva, Diego S" uniqKey="Silva D" first="Diego S" last="Silva">Diego S. Silva</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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