Department of Neurology, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Department of Psychology, Carleton University, Ottawa, Ontario, Canada.
PLoS One. 2020 Oct 22;15(10):e0238842. doi: 10.1371/journal.pone.0238842. eCollection 2020.
Under the pandemic conditions created by the novel coronavirus of 2019 (COVID-19), physicians have faced difficult choices allocating scarce resources, including but not limited to critical care beds and ventilators. Past experiences with severe acute respiratory syndrome (SARS) and current reports suggest that making these decisions carries a heavy emotional toll for physicians around the world. We sought to explore Canadian physicians' preparedness and attitudes regarding resource allocation decisions.
From April 3 to April 13, 2020, we conducted an 8-question online survey of physicians practicing in the region of Ottawa, Ontario, Canada, organized around 4 themes: physician preparedness for resource rationing, physician preparedness to offer palliative care, attitudes towards resource allocation policy, and approaches to resource allocation decision-making.
We collected 219 responses, of which 165 were used for analysis. The majority (78%) of respondents felt "somewhat" or "a little prepared" to make resource allocation decisions, and 13% felt "not at all prepared." A majority of respondents (63%) expected the provision of palliative care to be "very" or "somewhat difficult." Most respondents (83%) either strongly or somewhat agreed that there should be policy to guide resource allocation. Physicians overwhelmingly agreed on certain factors that would be important in resource allocation, including whether patients were likely to survive, and whether they had dementia and other significant comorbidities. Respondents generally did not feel confident that they would have the social support they needed at the time of making resource allocation decisions.
This rapidly implemented survey suggests that a sample of Canadian physicians feel underprepared to make resource allocation decisions, and desire both more emotional support and clear, transparent, evidence-based policy.
在 2019 年新型冠状病毒（COVID-19）引发的大流行期间，医生们面临着分配稀缺资源的艰难选择，包括但不限于重症监护床位和呼吸机。过去的严重急性呼吸系统综合症（SARS）经验和当前的报告表明，全球的医生在做出这些决策时承受着沉重的情感压力。我们试图探讨加拿大医生在资源分配决策方面的准备情况和态度。
2020 年 4 月 3 日至 13 日，我们对加拿大安大略省渥太华地区的医生进行了一项 8 个问题的在线调查，调查围绕着 4 个主题展开：医生对资源配给决策的准备情况、医生提供姑息治疗的准备情况、对资源分配政策的态度以及资源分配决策方法。
我们共收集了 219 份回复，其中 165 份用于分析。大多数（78%）受访者表示“有些”或“有点”准备好做出资源分配决策，而 13%的受访者表示“完全没有准备”。大多数受访者（63%）预计提供姑息治疗会“非常”或“有些困难”。大多数受访者（83%）强烈或有些同意应该有政策来指导资源分配。医生们一致认为某些因素在资源分配中非常重要，包括患者是否有可能存活，以及他们是否患有痴呆症和其他重大合并症。受访者普遍认为，在做出资源分配决策时，他们不会有足够的社会支持。
这项快速实施的调查表明，加拿大医生样本感到在做出资源分配决策方面准备不足，他们既需要更多的情感支持，也需要明确、透明、基于证据的政策。
