Harvard Radiation Oncology Program, Harvard University, Boston, Massachusetts, USA.
Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Harvard University, Boston, Massachusetts, USA.
Cancer. 2020 Sep 1;126(17):3896-3899. doi: 10.1002/cncr.32962. Epub 2020 May 28.
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.
治疗检测出严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)呈阳性的癌症患者带来了独特的挑战。在这篇评论中,作者描述了创建一个新的多学科治疗优先级委员会的伦理理由和实施细节,该委员会包括医生、一线工作人员、伦理学家和传染病专家。还讨论了对医疗保健工作者的组织义务。治疗优先级委员会设定了一个可接受的患者因癌症控制降低而受到伤害的阈值,这是合理的,可以降低对工作人员的风险。随着全国各部门都面临着关于治疗 SARS-CoV-2 阳性癌症患者的决策,创建一个涉及此类一线利益相关者的伦理、一致和透明的决策过程至关重要。