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Caring for Frail Older Adults During <scp>COVID</scp> ‐19: Integrating Public Health Ethics into Clinical Practice

Jocelyn Chase

2020Journal of the American Geriatrics Society29 citationsDOIOpen Access PDF

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, principles from both clinical and public health ethics cue clinicians and healthcare administrators to plan alternatives for frail older adults who prefer to avoid critical care, and for when critical care is not available due to crisis triaging. This article will explore the COVID-19 Ethical Decision Making Framework, published in British Columbia (BC), Canada, to familiarize clinicians and policy makers with how ethical principles can guide systems change, in the service of frail older adults. In BC, the healthcare system has launched resources to support clinicians in proactive advance care planning discussions, and is providing enhanced supportive and palliative care options to residents of long-term care facilities. If the pandemic truly overwhelms the healthcare system, frailty, but not age alone, provides a fair and evidence-based means of triaging patients for critical care and could be included into ventilator allocation frameworks. J Am Geriatr Soc 68:1666-1670, 2020.

Topics & Concepts

MedicineCoronavirus disease 2019 (COVID-19)2019-20 coronavirus outbreakGerontologySevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Public healthBetacoronavirusMEDLINEClinical PracticeFamily medicineNursingVirologyInternal medicineDiseaseInfectious disease (medical specialty)OutbreakLawPolitical scienceGeriatric Care and Nursing HomesFrailty in Older AdultsDisaster Response and Management
Caring for Frail Older Adults During <scp>COVID</scp> ‐19: Integrating Public Health Ethics into Clinical Practice | Litcius