Ethical aspects concerning prioritizing care in times of Covid-19

ABSTRACT

Healthcare providers, patients, policymakers and the public at large face unseen challenges due to the Covid-19 pandemic, including ethical questions that cover the entire healthcare landscape from the citizen who is subjected to specific prevention measures, primary care and residential care, and intensive care in specialized hospital wards. By consequence, prioritization decisions are made in different places in the healthcare landscape and by various actors. Moreover, different domains within the healthcare landscape may act as communicating vessels. For example, patients who are denied access to Intensive Care Units have to be cared for elsewhere, and the centralization of resources and manpower in hospitals may complicate access to tests, protective equipment or oxygen in primary care and residential care. Furthermore, the postponement of non-urgent care to create capacity for the care for covid patients has a significant impact on non-covid related care. Against this background, the Belgian Advisory Committee on Bio-ethics provides the current recommendations, in which four decision areas are considered the organization of care, the patient, medical professionals, and care institutions and primary care. The recommendations were endorsed by the Order of Physicians and the Superior Health Council.