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Treating the SARS-CoV-2-positive patient with cancer: A proposal for a pragmatic and transparent ethical process
Subha Perni1,2, Michael G Milligan1,2, Anurag Saraf1,2
1Harvard Radiation Oncology Program, Harvard University, Boston, Massachusetts, USA.
Abstract:
The treatment of patients with cancer who test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses unique challenges. In this commentary, the authors describe the ethical rationale and implementation details for the creation of a novel, multidisciplinary treatment prioritization committee, including physicians, frontline staff, an ethicist, and an infectious disease expert. Organizational obligations to health care workers also are discussed. The treatment prioritization committee sets a threshold of acceptable harm to patients from decreased cancer control that is justified to reduce risk to staff. The creation of an ethical, consistent, and transparent decision-making process involving such frontline stakeholders is essential as departments across the country are faced with decisions regarding the treatment of SARS-CoV-2-positive patients with cancer.
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