Oncology Care Delivery in the COVID-19 Pandemic: An Opportunity to Study Innovations and Outcomes
Pelin Cinar, John V. Cox, Arif H. Kamal, Kathleen Bickel, Monika K. Krzyzanowska, Jamés O. Armitage, Apar Kishor Ganti, Jeffery C. Ward, Sandra L. Wong, Sagar Lonial, Linda D. Bosserman
Abstract
PractitionersOncology professionals face complex challenges related to the COVID-19 pandemic.Practices are confronted with varying shortages of diagnostic tests, personal protective equipment, ventilators, and practice capacities; variable infection rates; a rising death toll; and the need to triage care while minimizing the risks to our patients, their caregivers, our colleagues, ourselves, and our families.In this context, the editors of JCO Oncology Practice have prioritized the publication of COVID-19-related articles providing early insights into how clinicians and practices are responding to COVID-19.These reports include duplicate information, yet such is reassuring, potentially defining best practice amid a natural experiment in crisis oncology care delivery. JCO OP Response to Help PractitionersCOVID articles published in JCO Oncology Practice incorporate existing evidence alongside expert opinion to address many ethical, organizational, and operational challenges.Some of the articles touch on crisis care delivery of disease-focused issues.The ASCO family of journals is working closely with ASCO's COVID-19 website to link key articles as soon as they are accepted, allowing early access before online publication. 1 Ethical Principles When Triage Is NeededPatients with cancer are greatly affected by both COVID-19 and policies around resource allocation.The ASCO Ethics Committee guidance provides an ethical framework to help practices make resource allocation decisions, balancing our duties of nonmalfeasance and justice. 2 Clinicians juggle roles-we are providers, colleagues, and family members-and in our effort to address patients' needs, our duty to those close to us creates moral conflicts; "we may perpetrate, bear witness to, or fail to prevent an act that transgresses our deeply held moral beliefs." 3 The ASCO Ethics Statement provides an articulation of the ethical rationale and the decision-making processes, making this burden easier to bear and to explain to worried patients and families.