All authors: Division of Pediatric Critical Care Medicine, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, MI.
Pediatr Crit Care Med. 2020 Oct;21(10):e924-e926. doi: 10.1097/PCC.0000000000002506.
Hospital visitation restrictions have been widely implemented during the coronavirus disease 2019 pandemic as a means of decreasing the transmission of coronavirus. While decreasing transmission is an important goal, it is not the only goal that quality healthcare must aim to achieve. Severely restricted visitation policies undermine our ability to provide humane, family-centered care, particularly during critical illness and at the end of life. The enforcement of these policies consequently increases the risk of moral distress and injury for providers. Using our experience in a PICU, we survey the shortcomings of current visitation restrictions. We argue that hospital visitation restrictions can be implemented in ways that are nonmaleficent, but this requires unwavering acknowledgment of the value of social and familial support during illness and death. We advocate that visitation restriction policies be implemented by independent, medically knowledgeable decision-making bodies, with the informed participation of patients and their families.
在 2019 冠状病毒病大流行期间,医院探视限制已广泛实施,作为降低冠状病毒传播的一种手段。虽然降低传播是一个重要目标,但它不是高质量医疗保健必须实现的唯一目标。严格的探视政策破坏了我们提供人道、以家庭为中心的护理的能力,特别是在重病和生命末期。这些政策的执行因此增加了提供者的道德困境和伤害的风险。利用我们在儿科重症监护病房的经验,我们调查了当前探视限制的缺陷。我们认为,可以以非恶意的方式实施医院探视限制,但这需要坚定不移地承认在疾病和死亡期间社会和家庭支持的价值。我们主张由独立的、有医学知识的决策机构实施探视限制政策,并让患者及其家属知情参与。