Multidisciplinary support for ethics deliberations during the first COVID wave

Area of Science:

• Medical Ethics
• Public Health Crises
• Healthcare Management

Background:

• The first COVID-19 wave in France (February 2020) caused concern over healthcare system saturation.
• A multidisciplinary Ethics-Support Cell (EST) was established to aid medical teams in navigating ethical dilemmas.

Purpose of the Study:

• To prospectively gather data on EST assistance requests during the initial COVID-19 wave.
• To document the functions and operational scope of the EST during this period.

Main Methods:

• An observational, real-time study of consultation requests for ethical dilemmas.
• A standardized data collection grid was used by the EST to ensure consistent information gathering.
• Interventions were limited to clinicians within the university hospital.

Main Results:

• 33 requests were analyzed, with a mean patient age of 80.8 years; most had COVID-19 and comorbidities.
• Requests primarily concerned Intensive Care Unit (ICU) admission and therapeutic proportionality.
• Dilemmas arose from limited resources and treatment intensity considerations.

Conclusions:

• Ethical dilemmas persisted despite established decision-making protocols during the COVID-19 crisis.
• EST interventions focused on patient-centered treatment, feasibility, and dignified care.
• The study underscores the value of ethical support and transparent decision-making in public health emergencies.