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Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?
Haward, Marlyse F; Janvier, Annie; Moore, Gregory P; Laventhal, Naomi; Fry, Jessica T; Lantos, John.
  • Haward MF; Albert Einstein College of Medicine.
  • Janvier A; Université de Montréal.
  • Moore GP; CHU Sainte-Justine.
  • Laventhal N; Children's Hospital of Eastern Ontario.
  • Fry JT; University of Ottawa.
  • Lantos J; University of Michigan.
Am J Bioeth ; 20(7): 37-43, 2020 07.
Article in English | MEDLINE | ID: covidwho-245575
ABSTRACT
In a crisis, societal needs take precedence over a patient's best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. But surviving babies will likely live longer, maximizing life-years. Empiric evidence demonstrates that these babies can derive significant survival benefits from ventilation when compared to adults. When "triaging" or choosing between patients, justice demands fair guidelines. Premature babies do not deserve special consideration; they deserve equal consideration. Solidarity is crucial but must consider needs specific to patient populations and avoid biases against people with disabilities and extremely premature babies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Triage / Coronavirus Infections / Infant, Extremely Premature / Betacoronavirus Type of study: Case report / Prognostic study Limits: Aged / Female / Humans / Male / Infant, Newborn Language: English Journal: Am J Bioeth Journal subject: Ethics Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Triage / Coronavirus Infections / Infant, Extremely Premature / Betacoronavirus Type of study: Case report / Prognostic study Limits: Aged / Female / Humans / Male / Infant, Newborn Language: English Journal: Am J Bioeth Journal subject: Ethics Year: 2020 Document Type: Article