Clinical care for COVID-19

Communication Skills in the Age of COVID-19, co-authored by Center faculty member Robert Arnold, Chief of the Department of Medicine’s Section of Palliative Care and Medical Ethics, and Director of the Institute for Doctor-Patient Communication, presenting a “talking-map” to discuss care planning with critically ill patients and their families during the pandemic, April 2020

A Conversation about Ethical Issues Arising with Use of Telemedicine during This Pandemic, with Gary Fischer, Professor of Medicine and Biomedical Informatics, and Medical Director, Clinical Decision-Support and Analytics, Ambulatory eRecord at the University of Pittsburgh, part of the Pandemic Policies & Practices series co-sponsored by the Mid-Atlantic Regional Public Health Training Center and the Center for Bioethics & Health Law, June 23, 2020

ICU and Palliative Care services have been profoundly affected during the pandemic in ways that raise ethical questions for care during the pandemic and in general:

• "You Can See Your Loved One Now." Can Visitor Restrictions During Covid Unduly Influence End-of-Life Decisions? considers whether visitation restrictions not only made for gut-wrenching experiences for patients and families, but also unduly influenced end-of-life decisions, even being perceived as coercive, June 18, 2020 
• Not Dying Alone — Modern Compassionate Care in the Covid-19 Pandemic, a NEJM perspective piece considering how technologies may be employed to ease the pain of patients and their families at the end of life, June 11, 2020
• The Hastings Center has collected articles on the relief of suffering during the pandemic, access to palliative drugs, and considerations of justice

Life After COVID-19: The Road to Recovery, May 14, 2020, surveying the wide range of symptoms and immediate and longer-term outcomes observed thus far

In Should New Mothers with Covid-19 Be Separated From Their Newborns? the authors analyze conflicting guidance and the empirical evidence regarding this question and conclude that “unless a mother consents to separation, there is currently no basis for a medical team to override parental decision-making rights for their child,” May 11, 2020

ICU Delirium’ is Leaving COVID-19 Patients Scared and Confused—In “regular” times, delirium has been infrequently discussed with patients entering or likely to enter the ICU; this brief article from The Atlantic (May 5, 2020) can help to prepare patients and families during this pandemic. See also The Atlantic’s June 7, 2020 article The Overlooked Danger of Delirium in Hospitals (not part of its free COVID-19 coverage)

DoD COVID-19 Practice Management Guide – Clinical management of COVID-19

Some special issues related to pediatrics are described in this 2011 paper: Ethical issues in pediatric emergency mass critical care

University of Washington resources, on its public site, including protocols regarding personal protective equipment, staff precautions, patient care, and autopsy