key: cord-0067169-1dx78aa2
authors: Breiburg, A.; Kuschner, W.G.
title: Reducing moral distress associated with rationing of healthcare resources
date: 2021-03-24
journal: Ethics Med Public Health
DOI: 10.1016/j.jemep.2021.100655
sha: eb3ec53ce8f6521f1ff327041acd77b362883e43
doc_id: 67169
cord_uid: 1dx78aa2

nan

. In considering the ethical challenges of ''bedside rationing'', the authors state, ''any decision on rationing. . .is going to put the physician under severe moral distress''. We believe a discussion of moral distress attributable to bedside rationing should make note of specific strategies to reduce the potential for this harm to develop.

Deliberate planning can reduce the moral distress that health care professionals might experience when shifting from the usual standards of care to crisis standards of care in which critically ill individual who would normally receive any reasonable therapy may receive limited treatment or non-traditional provision of care [2] . Triage teams provide a command structure that can oversee operations during a crisis period characterized by a need for rapid and ethically challenging decision-making and provide a structure for addressing the inevitable tensions that arise between clinicians' professional commitment to individual patients and the simultaneous goal of maximizing the survivability of the greatest numbers of persons [3] . The triage team, not the bedside physician, assumes responsibility for implementation of a triage protocol and, in turn, the equitable allocation of available resources. Triage teams, which function in coordination with, but independently of, the treating physician have an important role in mitigating moral distress and ethical conflict. The intervention of triage teams utilizing a scarce resource allocation protocol takes some of the most difficult decision-making during crisis standards of care away from the ''bedside physician'' and provides a structured approach to rationing during a health care crisis that can be fair, equitable, transparent, and efficient.

Ethical rationing of healthcare resources during COVID-19 outbreak: review

The Pandemic Influenza Ethics Initiative Work Group of the Veterans Health Administration's National Center for Ethics in Health Care. Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and Health Care Professionals in the Veterans Health Administration

The authors declare that the work described has not involved experimentation on humans or animals.

The authors declare that the work described does not involve patients or volunteers.

This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.

All authors attest that they meet the current International Committee of Medical Journal Editors (ICMJE) criteria for Authorship.

The authors declare that they have no competing interest.