Guiding Cardiac Care During the COVID-19 Pandemic: How Ethics Shapes Our Health System Response.
Journalcanadian journal of cardiology5Date
2020 Jun 04
4 months ago
Journal Article
2020-08 / 36 : 1313-1316
Virani A 1, Singh G 2, Bewick D 3, Chow CM 4, Clarke B 5, Cowan S 6, Fordyce CB 6, Fournier A 7, Gin K 6, Gupta A 8, Hardiman S 9, Jackson S 10, Lamarche Y 11, Lau B 6, Légaré JF 3, Leong-Poi H 4, Mansour S 12, Marelli A 13, Quraishi A 10, Roifman I 14, Ruel M 15, John Sapp 10, Small G 15, Turgeon R 16, Wood DA 6, Zieroth S 17, Virani S 6, Krahn AD 6
  • 2. Mazankowski Alberta Hearth Institute, Division of Cardiac Surgery, Departments of Critical Care Medicine and Surgery, University of Alberta, Edmonton, Alberta, Canada.
  • 3. New Brunswick Heart Centre, Saint John, New Brunswick, Canada.
  • 4. Division of Cardiology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
  • 5. Libin Cardiovascular Institute, Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada.
  • 6. Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
  • 7. Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Québec, Canada.
  • 8. Trillium Health Partners, University of Toronto, Mississauga, Ontario, Canada.
  • 9. Cardiac Services BC, Provincial Health Services Authority, Vancouver, British Columbia, Canada.
  • 10. QEII Health Sciences Center, Division of Cardiology, Dalhousie University Halifax, Halifax, Nova Scotia, Canada.
  • 11. Department of Surgery, Montréal Heart Institute, Université de Montréal, Montréal, Québec, Canada.
  • 12. Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
  • 13. Department of Medicine, McGill University Health Center, McGill University, Montréal, Québec, Canada.
  • 14. Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
  • 15. University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
  • 16. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
  • 17. University of Manitoba, Winnipeg, Manitoba, Canada.
Cardiology Service, Hospital
Cardiovascular Diseases
Coronavirus Infections
Ethics, Institutional
Infection Control
Models, Organizational
Organizational Innovation
Patient Care Management
Pneumonia, Viral
The COVID-19 pandemic has raised ethical questions for the cardiovascular leader and practitioner. Attention has been redirected from a system that focuses on individual patient benefit toward one that focuses on protecting society as a whole. Challenging resource allocation questions highlight the need for a clearly articulated ethics framework that integrates principled decision making into how different cardiovascular care services are prioritized. A practical application of the principles of harm minimisation, fairness, proportionality, respect, reciprocity, flexibility, and procedural justice is provided, and a model for prioritisation of the restoration of cardiovascular services is outlined. The prioritisation model may be used to determine how and when cardiovascular services should be continued or restored. There should be a focus on an iterative and responsive approach to broader health care system needs, such as other disease groups and local outbreaks.
Can J Cardiolcanadian journal of cardiology

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