Pautas éticas para la asignación de recursos sanitarios escasos en el marco de la pandemia por COVID-19 en Colombia
DOI:
https://doi.org/10.30944/20117582.653Palabras clave:
COVID-19, virus del SRAS, coronavirus, infecciones por coronavirus, pandemias, ética médica, recursos en saludResumen
La pandemia por COVID-19 ha traído una inmensa presión sobre recursos sanitarios limitados, que incluyen personal de salud, elementos de protección personal y, de manera especialmente preocupante, camas de cuidado intensivo, ventiladores y demás equipos requeridos para el cuidado crítico.
Descargas
Referencias bibliográficas
Carrera a muerte por los respiradores para salvar infectados por coronavirus. REVISTA SEMANA, 4 Abril 2020. Disponible en: https://www.semana.com/nacion/articulo/coronavirus-en-colombia-hay-suficientes-ventiladores-pulmonares-en-el-pais/661534
Presidencia de la República de Colombia. Gobierno adquirió 2.100 ventiladores para fortalecer unidades de cuidados intensivos (UCI) en el país. Noticia de la presidencia República de Colombia. 4 Abril 2020.
Sheri F. The hardest questions doctors may face: Who will be saved? Who won’t? The New York Times, March 22, 2020. Section A, Page 16. Disponible en: https://www.nytimes.com/2020/03/21/us/coronavirus-medical-rationing.html
Central Ethics Committee (CEC), the Executive Board of the Swiss Academy of Medical Sciences and the Board of the Swiss Intensive Care Medicine Society (SGI-SSMI). COVID-19 pandemic: triage for intensive-care treatment under resource scarcity. Swiss Med Wkly; 150: w 20229, 2nd, version. Actualizada Marzo 24, 2020. Disponible en: https://smw.ch/article/doi/smw.2020.20229
Kipnis K. Triage and ethics. AMA Journal of Ethics. 2002;4(1). Disponible en: https://journalofethics.ama-assn.org/article/triage-and-ethics/2002-01
Daugherty-Biddison E, Faden R, Mareiniss D, Regenberg A, Schoch-Spana M, Schwartz J, Toner E. Too many patients…A framework to guide statewide allocation of scarce mechanical ventilation during disasters. Contemporary Reviews in Critical Care Medicine. 2019;155:848-54. Disponible en: https://journal.chestnet.org/article/S0012-3692(18)32565-0/pdf
University of Pittsburg. Department of Critical Care Medicine. School of Medicine. Allocation of scarce critical care resource during a public health emergency. 2020. Disponible en: https://ccm.pitt.edu/sites/default/files/UnivPittsburgh_ModelHospitalResourcePolicy_2020_04_15.pdf
White DB, Lo B. A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. JAMA. 2020 Mar 27. Online ahead of print. https://doi.org/10.1001/jama.2020.5046
White DB, Katz MH, Luce JM, Lo B. Who should receive life support during public health emergency? Using ethical principles to improve allocation decisions. Ann Inter Med. 2009;150:132-8.
Emanuel EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med. 2020 Mar 23. Online ahead of print. https://doi.org/10.1056/NEJMsb2005114
Christian MD, Sprung C, King MA, Dichter JR, Kissoon N, Devereaux AV, et al. Triage: Care of the Critically Ill and Injured During Pandemics and Disasters: CHEST Consensus Statement. Chest. 2014;146(4 Suppl):e61S-74S. https://doi.org/10.1378/chest.14-0736
Berlinger N, Wynia M, Powell T, Hester DM, Milliken A, Fabi R, et al. Ethical framework for health care institutions responding to novel coronavirus SARS-CoV-2 (COVID-19) The Hasting Center. 2020 March 16. Disponible en: https://snlg.iss.it/wp-content/uploads/2020/03/AA-Hastings-Center-Covid-Framework-2020.pdf
NHS England and NHS Improvement .Clinical guide for the management of palliative care in secondary care during the coronavirus pandemic, Version 1. 2020. Disponible en: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0081-Speciality-guide-Palliative-care-and-coronavirus-FINAL-02.04.20.pdf
Entscheidungen über die Zuteilung von Ressourcen in der Notfall- und der Intensivmedizin im Kontext der COVID-19-Pandemie. Klinisch-ethische Empfehlungen, Von den Fachgesellschaften verabschiedete Fassung vom 25.03.2020 (Germany). Disponible en: https://pneumologie.de/fileadmin/user_upload/Aktuelles/2020-03-25_COVID-19_Ethik_Empfehlung_Endfassung_2020-03-25.pdf
Bioethikkommission (Austria). (2020) Zum Umgang mit knappen Ressourcen in der Gesundheitsversorgung im Kontext der Covid-19-Pandemie, Bundesklanzleramt website. Disponible en: https://www.bundeskanzleramt.gv.at/themen/bioethikkommission/publikationen-bioethik.html
Illinois Department of Public Health. Esf-8 plan: catastrophic incident response annex. March 2018. Disponible en: http://www.dph.illinois.gov/sites/default/files/publications/catastrophic-incident-response-annex-052218.pdf
New York State Department of Health. New York State Task force on life and the law. Ventilator allocation guidelines. 2015. Disponible en: https://www.health.ny.gov/regulations/task_force/reports_publications/docs/ventilator_guidelines.pdf
Tennessee Altered Standards of Care Workgroup. Guidance for the ethical allocation of scarce resources during a community-wide public health emergency as declared by the governor of Tennessee. Versión 1.6, July 2016. Disponible en: http://www.midsouthepc.org/wp-content/uploads/2018/05/2016_Guidance_for_the_Ethical_Allocation_of_Scarce_Resources.pdf
UNESCO International Bioethics Committee (IBC), UNESCO World Commission on the Ethics of Scientific Knowledge and Technology (COMEST). UNESCO Statement on covid-19: ethical considerations from a global perspective. 2020. Disponible en https://unesdoc.unesco.org/ark:/48223/pf0000373115
Comité de Bioética de España. Informe del comité de bioética de españa sobre los aspectos bioéticos de la priorización de recursos sanitarios en el contexto de la crisis del coronavirus. 2020. Disponible en: http://assets.comitedebioetica.es/files/documentacion/Informe%20CBE-%20Priorizacion%20de%20recursos%20sanitarios-coronavirus%20CBE.pdf
República de Colombia. Consejo Nacional de Bioética. Declaración del Consejo Nacional de Bioética. Marzo 19 de 2020. Disponible en: https://minciencias.gov.co/sites/default/files/declaracion_cnb_sobre_covid19.pdf
Klugman C. COVID Chronicles: What does triage mean, how does it work, and when will we need it. Bioethics.net (blog). Mar 17, 2020. Disponible en: http://www.bioethics.net/2020/03/covid-chronicles-what-does-triage-mean-how-does-it-work-and-when-will-we-need-it/
Romeo N. The grim ethical dilemma of rationing medical care, explained: How hospitals decide which Covid-19 patients to prioritize when resources are scarce. Vox. Mar 31, 2020. Disponible en: https://www.vox.com/coronavirus-covid19/2020/3/31/21199721/coronavirus-covid-19-hospitals-triage-rationing-italy-new-york
Truog R, Mitchell C, Daley G. The toughest triage — Allocating ventilators in a pandemic. N Engl J Med. 2020 Mar 23. Online ahead of print. https://doi.org/10.1056/NEJMp2005689
Christian M. Triage. Critical Care Clinics. 2019;35:575–89. https://doi.org/10.1016/j.ccc.2019.06.009
Novoa A. Criterios éticos y organizativos para tomar decisiones en condiciones de escasez. El modelo adaptativo. Nogracias, marzo 20, 2020.
Strosberg M. Allocating Scarce Resources in a Pandemic: Ethical and Public Policy Dimensions, Virtual Mentor. 2006;8:241-4. https://doi.org/10.1001/virtualmentor.2006.8.4.pfor3-0604
Guest T, Tantam G, Donlin N, Tantam K, McMillan H, Tylliard A. An observational cohort study of triage for critical care provision during pandemic influenza: ‘clipboard physicians’ or ‘evidenced based medicine’?. Anaesthesia. 2009;64:1199-206. https://doi.org/10.1111/j.1365-2044.2009.06084.x
Asociación Colombiana de Cuidados Paliativos. Recomiendaciones de la Asociación Colombiana de Cuidados Paliativos para la atención clínica de paciente durante la pandemia por SARS – COV-2 / COVID-19. 2020. Disponible en: https://www.accpaliativos.com/wp-content/uploads/2020/04/Recomendaciones-COVID19-ACCP.pdf

Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Todos los textos incluidos en la Revista Colombiana de Cirugía están protegidos por derechos de autor. Las opiniones expresadas en los artículos firmados son las de los autores y no coinciden necesariamente con las de los directores o los editores de la Revista Colombiana de Cirugía. Las sugerencias diagnósticas o terapéuticas como elección de productos, dosificación y métodos de empleo corresponden a la experiencia y al criterio de los autores.