Coronavirus Update: Ethics Considerations, Guidance and Resources.
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COVID-19 Resources for Health Care Providers & Facilities

Note: Providers or health care facilities, please email Cindy Bruzzese for a copy of the UVMMC COVID Palliative Care Provider Toolkit.

Ethics & Policy Considerations for Reopening the Economy

When to Reopen the Nation is an Ethics Question—Not Only a Scientific One (The Hastings Center)

An article explaining how deciding how to move forward is a decision about values, not just data.

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Grappling With the Ethics of Social Distancing (Johns Hopkins Berman Institute of Bioethics)

A working paper that provides a framework for evaluating social distancing policies and reopening plans.

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Roadmap to Pandemic Resilience (Edmond J. Safra Center for Ethics at Harvard University)

A comprehensive operational roadmap for mobilizing and reopening the U.S. economy in the midst of the COVID-19 crisis.

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Show Me Your Passport: Ethical Concerns About COVID-19 Antibody Testing as Key to Reopening Public Life (The Hastings Center)

An article exploring the ethics, including obstacles and disparities, of so-called immunity passports.

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Allocating Scarce Resources: Model Policies and Additional Guidance

UVM Health Network Plan for Ethical Allocation of Hospital Beds and Mechanical Ventilators During the COVID-19 Epidemic

Guidelines that aim to clarify a pragmatic approach to the wise allocation of hospital beds and mechanical ventilators for use by frontline health care workers. This policy is being discussed with various stakeholders and will be updated as needed.

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Additional Guidance for Hospital Ventilator Allocation Policies

By Doug White, MD, MAS, Endowed Chair for Ethics in Critical Care Medicine at the University of Pittsburgh Medical Center and Director of the Program on Ethics and Decision Making in Critical Illness

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Ventilator Allocation Guideline by New York Task Force on Life and the Law

Clinical ventilator allocation protocols in New York state.

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Ethical Considerations for Allocation of Vents During a Pandemic (CDC)

A comprehensive look at priorities for allocation, principles that should guide allocation, who should make allocation decisions, and other considerations.

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The Toughest Triage — Allocating Ventilators in a Pandemic (New England Journal of Medicine)

An ethical perspective on the prospect of rationing ventilators during the COVID-19 pandemic.

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What US Hospitals Should Do Now to Prepare for a COVID-19 Pandemic

An article that offers American hospital administrators and clinicians specific judgment on what hospitals should do to prepare for a COVID-19 pandemic.

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Projected Hospital Resource Use During COVID-19 (Institute for Health Metrics & Evaluation)

Projections and data visualizations of hospital resource use for the U.S. and by state (indicates projected peak and how many overall beds, ICU beds, and ventilators will be needed).

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COVID-19: Advice From the Front Lines (American College of Chest Physicians)

Interviews with physicians who are on the frontlines as webinars and on-demand content, including a discussion on triage of critical care resources.

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Ethics Considerations & Resources

Ethics Resources on the Coronavirus (The Hastings Center)

A compilation of ethics resources for responding to the Coronavirus.

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Supporting Ethical Care and Responding to Moral Distress in a Public Health Emergency (The Hastings Center)

A slide deck with guidance, tools, and resources for Hospital Ethics Committees (HECs) and Clinical Ethics Consultation (CEC).

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Responding to COVID-19 as a Regional Public Health Challenge: Preliminary Guidelines for Regional Collaboration Involving Hospitals (The Hastings Center)

A supplement to The Hastings Center's Ethical Framework that aims to help structure discussion of ethical concerns in responding to Covid-19 as a regional public health challenge and support collaboration across institutions throughout pandemic response and recovery.

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Acccess to Therapeutic and Palliative Drugs in the Context of COVID-19: Justice and the Relief of Suffering

A supplement to The Hastings Center's Ethical Framework that aims to to help structure discussion of significant, foreseeable ethical concerns in responding to Covid-19 and to support collaboration across institutions throughout pandemic response and recovery.

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On the Verge of Making Triage Decisions: Understanding Justice in Medicine

by Rosamond Rhodes, Ph.D., Professor of Medical Education, Director of Bioethics Education, Icahn School of Medicine at Mount Sinai

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Pandemic Justice: Clarifying Guidance for Resource Allocation (Bioethics.net)

An article by Rosamond Rhodes, Ph.D. that suggests we limit guiding principles to just three principles of justice.

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Clinical Ethics Recommendations for the Allocation of Intensive Care Treatments in Exceptional, Resource-Limited Circumstances (SIAARTI)

A guide from Italy translated into English that addresses a potential imbalance between the real clinical needs of the population and the effective availability of intensive resources.

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Veteran Health Association Ethical Guidance

An ethical guide to assist VA facilities in pandemic workforce, communications, and patient care planning.

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Who Should Receive Life Support During a Public Health Emergency? (Annals of Internal Medicine)

An analysis of ethical principles that could guide resource allocation and a proposed strategy that balances multiple morally relevant considerations.

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AMA Code of Medical Ethics: Guidance in a Pandemic

Offers foundational guidance for health care professionals and institutions responding to the COVID-19 pandemic.

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Roles for Ethicists in COVID-19 Response (Impact Ethics)

Describes the role of health care ethicists in a pandemic.

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Confronting Disability Discrimination During the Pandemic (The Hastings Center)

An essay on developing a triage protocol that will minimize rather than magnify structural discrimination, such as ableism, in the health care system.

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Bioethics Toolkit for COVID-19 (Bioethics.net)

A collection of bioethics resources from the American Journal of Bioethics for people dealing with COVID-19.

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In Response to COVID-19 Pandemic Physicians Already Know What to Do (Bioethics.net)

An article that argues we should not rush to develop brand new criteria for allocating scarce resources in intensive care units (ICUs), but should instead rely on what bioethicists have learned over many years.

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The COVID-19 Pandemic: Critical Care Allocated in Extremis (Bioethics.net)

A commentary on the previous article that offers additional considerations.

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Interim Guidance for Basic and Advanced Life Support in Children and Neonates With Suspected or Confirmed COVID-19 (American Heart Association)

Interim guidance to help rescuers treat victims of pediatric cardiac arrest with suspected or confirmed COVID-19.

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Communication Tools

Conversation Toolkit For COVID-19 (TalkVermont)

A toolkit to help clinicians in our community respond to the epidemic.

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TalkVermont

Tools for clinicians to skillfully and compassionately engage in conversation about what matters most to them.

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The Importance of Addressing Advance Care Planning and Decisions About Do-Not-Resuscitate Orders During COVID-19 (JAMA)

An article addressing the importance of providing goal-concordant care and how advance care planning should be a high priority in the context of this pandemic.

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Communicating in a Crisis: Skills to Honor Previously Determined Preference for Medical Care (OHSU)

A video demonstrating practical communication techniques for having conversations about goals of care with seriously ill patients (and their surrogates) who have pre-existing COLST orders to limit treatments.

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Communicating with the Public about COVID-19 and Advance Care Planning (Massachussetts Coalition for Serious Illness Care)

Public messaging guidance to support appropriate advance care planning at this time and create consistent language.

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Proactive Care Planning for COVID-19: a Guide for Clinicians to Help Individuals (Respecting Choices)

A guide for use by clinicians to proactively help individuals at highest risk for complications associated with COVID-19 express their desires for care in the event they develop the infection.

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Proactive Care Planning for COVID-19: a Guide for Clinicians to Help Health Care Agents (Respecting Choices)

A guide for use by clinicians to proactively help health care agents of individuals at highest risk for complications associated with COVID-19 express their desires for care, in the event the individual develops the infection.

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How to Have a Proactive Care Planning Conversation in the Context of COVID-19 (Respecting Choices)

A prerecorded webinar to support clinicians in having proactive planning conversations with patients at risk for the infection and developing plans for care that align with their goals and preferences.

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Basic Advance Care Planning Scripts for All Outpatient Healthcare Professionals (PREPARE for Your Care)

Appropriate regardless of discipline or training - no experience necessary. Developed by PREPARE For Your Care for the COVID-19 crisis.

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COVID-19: Deaf and Hard of Hearing Communication Access Recommendations for the Hospital (National Association of the Deaf)

Guidance and tools for hospitals, medical facilities, and medical professionals to provide communication services to deaf and hard of hearing patients.

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COVID-19 Multilingual Video Resources (Equal Access Language Services)

A public service initiative to provide basic information about COVID-19 in as many languages as possible.

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COVID-19 Resources in Indigenous Languages (CIELO)

A compilation of COVID-19 educational resources, including videos, in indigenous languages.

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Responding to COVID-19: A Science-Based Approach (American Public Health Association & National Academy of Medicine)

A webinar series exploring the scientific basis for guidance issued by government, health and public health organizations, as well as answers to commonly asked questions.

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Building Capacity & Supporting Health Care Workers

Critical Care for the Non-ICU Clinician (Society of Critical Care Medicine)

Online education resources for non-ICU clinicians who may be needed to care for critically ill patients as the COVID-19 pandemic spreads.

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Sustaining Healthcare Personnel During Coronavirus (Center for the Study of Traumatic Stress)

A one-page summary on how take care of yourself and encourage others to practice self-care, which sustains the ability to care for those in need.

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Caring for Yourself and Caring for Others During a Disaster/Epidemic (OHSU)

A video presentation offering helpful reminders for each of us as we work to meet the challenge of this epidemic.

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Managing Workload and Referrals During Peak or Crisis Periods (Center to Advance Palliative Care)

How to proactively work with key referring providers to manage workload and adjust team processes and priorities.

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Emergency Health Workforce Policies to Address COVID-19 (GWU Fitzhugh Mullan Institute for Health Workforce Equity)

A webinar series that focuses on actions that we can take now to avoid entering a vicious cycle of staffing shortages.

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Keeping the Coronavirus from Infecting Healthcare Workers (The New Yorker)

An article by Dr. Atul Gawande on what Singapore and Hong Kong's success is teaching us about the pandemic.

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Palliative Care Team Health and Resiliency During the COVID-19 Pandemic (Center to Advance Palliative Care)

Nine practical, specific strategies for supporting team health during the COVID-19 pandemic.

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Decompress Podcast

A daily podcast from Tony Back, MD, co-founder of VitalTalk, about what health care professionals can do to sustain themselves during COVID-19.

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Sustaining Clinical Empathy During the Pandemic (The Hastings Center)

An article on what clinicians can do to sustain and preserve empathy during the COVID-19 crisis.

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Tips for Improving Staff Wellbeing During COVID-19 (Institute for Healthcare Improvement)

Suggestions for how to prioritize staff wellbeing and joy in work now instead of waiting for circumstances to worsen.

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What to Do and Say to Support Psychological Safety During the COVID-19 Pandemic (Institute for Healthcare Improvement)

Advice from a group of safety and quality leaders on how to preserve and foster psychological safety for those providing and managing care.

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Conversation and Action Guide to Support Staff Wellbeing and Joy in Work During and After the COVID-19 Pandemic (Institute for Healthcare Improvement)

Actionable ideas that leaders can quickly test during the pandemic response, and which can build a longer-term foundation to sustain joy in work for the health care workforce.

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Nursing Home Considerations

COVID-19 in Nursing Homes with Hospice Patients (NHPCO)

A short guide on visitation, with specific guidance for certain compassionate care situations, such as end-of-life, and details for hospice workers in nursing homes.

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Guidance for Infection Control and Prevention of COVID-19 in Nursing Homes (CMS)

Guidance from the Centers for Medicare and Medicaid Services to nursing homes to help control and prevent the spread of the virus.

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Vermont Resources

Vermont Department of Health: Novel Coronavirus (COVID-19)

Guidance for health care professionals from VDH, including how to report suspect cases, submit resource requests, and more.

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Vermont Department of Disabilities, Aging & Independent Living (DAIL): Novel Coronavirus Information

Information for long-term care facilities, caregivers, developmental services providers, hospitals, home-based services, and more.

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The University of Vermont Health Network (UVMHN): Coronavirus (COVID-19)

Information for health care professionals, including current testing criteria, protocols, educational materials, and more.

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Vermont Crisis Standards of Care Plan (VT Department of Health)

Comprehensive guidance on managing disasters and emergencies within the state of Vermont that threaten healthcare and public health.

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Federal Resources

Centers for Disease Control and Prevention (CDC): COVID-19 Information for Healthcare Professionals

Resources for healthcare professionals from the CDC, including current guidance, infection control resources, preparedness tools, and more.

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Centers for Medicare and Medicaid Services (CMS): Coronavirus

Information and updates from CMS, including clinical, technical, billing, coding, and coverage guidance.

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FDA Fact Sheet on Emergency Use Authorization (EUA) for COVID-19 Convalescent Plasma Use

This fact sheet is designed for patients and parents/caregivers to help understand the risks and benefits of taking COVID-19 convalescent plasma.

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Hospice and Palliative Care Services During COVID-19

Hospice and palliative care agencies across the state are continuing to offer services during the COVID-19 pandemic. Below are overviews by agency of the services each are delivering (we will continue to add more as they become available):