Approaching "Elective" Surgery in the Era of COVID-19.
J Hand Surg Am
; 46(1): 60-64, 2021 01.
Article
in English
| MEDLINE | ID: covidwho-802094
ABSTRACT
The coronavirus disease 2019 pandemic created unprecedented challenges for the health care system. To meet capacity demands, hospitals around the world suspended surgeries deemed to be elective. In hand surgery, numerous pathologies are treated on an elective basis, but a delay or absence of care may result in poorer outcomes. Here, we present an ethical framework for prioritizing elective surgery during a period of resource scarcity. Instead of using the term "elective," we define procedures that can be safely delayed on the basis of 3 considerations. First, a safe delay is possible only if deferral will not result in permanent injury. Second, a delay in care will come with tolerable costs and impositions that can be appropriately managed in the future. Third, a safe delay will preserve the bioethical principle of patient autonomy. In considering these criteria, 3 case examples are discussed considering individual patient characteristics and the pathophysiology of the condition. This framework design is applicable to ambulatory surgery in any period of crisis that may strain resources, but further considerations may be important if an operation requires hospital admission.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Radius Fractures
/
Carpal Tunnel Syndrome
/
Elective Surgical Procedures
/
COVID-19
/
Ligaments, Articular
Limits:
Humans
Language:
English
Journal:
J Hand Surg Am
Year:
2021
Document Type:
Article
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