Coronavirus Update: Ethics Considerations, Guidance and Resources.
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Conversations about advance directives are important to ensure dignity in life and in death. In one nationally representative survey, however, older black Americans were half as likely as older whites to have advance directives.
The coronavirus has left tens of thousands of grief-stricken American families struggling to make sense of the seemingly random terror it inflicts, sickening many but only taking some lives. But for many black families, mourning coronavirus deaths brings an added burden as they wonder whether racial bias may have played a role.
Now, more than ever, you need to have multiple conversations. Why? It helps normalize the topic.
As Covid-19 continues to spread throughout the United States, doctors, nurses, and other clinicians are facing unmistakable tragedies. But something less perceptible is afoot. Empathy in medicine is under siege.
The data are clear: African Americans are becoming infected with the novel coronavirus and dying at a higher rate than White Americans. The rationale is clear: African Americans have higher rates of comorbid conditions than White Americans. The reason is clear: over 400 years of systematic racism, institutional oppression, and continued colorblindness have lead to this outcome.
Every Wednesday from 10-11 am, beginning May 6, Brattleboro Area Hospice’s Taking Steps Brattleboro program will host an Advance Care Planning/Advance Directive Question and Answer Information Session via Zoom.
The novel coronavirus pandemic has starkly revealed the vulnerabilities of low-wage immigrants, immigrant-led households, and immigrant communities to coronavirus infection, severe Covid-19 illness, and economic fallout from pandemic.
When deciding which patients with Covid-19 should get scarce ventilators, should hospitals consider a person’s DNR status – the previously stated wish not to receive cardiopulmonary resuscitation (CPR) to restart the heart and breathing after cardiac arrest?
It’s been painful to watch health leaders twist themselves into moral knots denying that recently created ventilator rationing guidance will differentially affect Blacks, Latinx, and other people of color. On television, in newspapers, and on listservs, when the predicted disproportionate impacts of these policies are raised, some bioethicists-often white, stonewall.
In the rush to find a Covid-19 vaccine and one or more drugs to treat the deadly disease, concerns are being raised that ethical standards for conducting human clinical trials, and the evidentiary standards for determining whether interventions are safe and effective, might be loosened.
Rationing ventilators might be a necessary response in the new Covid-19 world. Many hospitals decide who gets them by selecting patients most likely to benefit. Experts agree this is the best way of saving most lives. The approach, the model guidance, may sound fair. But baked into it are biases that disadvantage groups who, even without a Covid-19 infection, experience worse health because of historical and structural reasons, especially black people.
Do the elderly have special obligations during a pandemic, that is, something more than the duty we all have for hand washing, social distancing, timely self-quarantining, and most recently, wearing a face mask?
In recent weeks, some disability advocates have objected to triage policies. These critics argue that people with disabilities are likely to get lower priority under triage policies. They worry that doctors will judge disabled people as having a lower quality of life and so as less deserving of being saved, and that disabled people who need more medical assistance will be excluded.
The journey the task force took in its thinking from early drafts to its final 2015 report was a salubrious one. It shows that people of good faith can evolve in their thinking about fairness, justness, and disability, especially when cajoled by passionate scholars…
“As a 71-year-old bioethicist, I recently drew up an advance directive specifically for the possibility that I might have to go to the hospital with Covid-19, and I am writing this essay to explain why I consider rationing mechanical ventilation based on age to be one morally relevant criterion.”
In the next few weeks, as the pandemic perhaps reaches its zenith, we will have the opportunity to decide once again what sort of society we intend to be. We should eschew all invidious discrimination and recommit ourselves to treating all who are ill as bearers of profound, inherent, and equal worth and dignity.
VEN’s Spring Conference, “Informed Consent: More Than a Piece of Paper”, has been postponed until the fall.
View the results of our Ethics Survey for Vermont & New Hampshire conducted in the summer of 2019.