The UP Manila COVID-19 Ethics Study Group has released Version 1 of the Ethics Guidelines on COVID-19 Crisis-Level Hospital Care last March 20. The multidisciplinary Group composed of Drs. Alvin Caballes, Lenora Fernandez, Ma. Bella Siasoco, and Prof. Peter Sy (team leader) seeks to provide guidance on resource-allocation and other ethical issues in the care of COVID-19 patients amidst the unprecedented pandemic crisis, acute scarcity of medical resources, and threats to healthcare workers.
The document has been endorsed by various medical and patient groups, as it gives “handles on how to provide appropriate and compassionate patient care in times of crisis” (Philippine Alliance of Patient Organizations). The Philippine College of Physicians maintains that the Guidelines “can serve as a template for hospitals to pattern their management set-up to address ethical issues concerning the entire healthcare system and the patients under its care. It is very comprehensive and the discussions are detailed but simple and easy to follow.”
The document covers diverse issues and concerns: the ethical Principles of fairness and duty to dare to justify the rest of the guidelines; an Admission Triage that safely and systematically assigns patients to appropriate care, beyond the potentially narrow concerns of individual hospitals and care givers; Communication of Care, especially given the delicate, time-sensitive, complex nature of COVID-19 hospitalization that may involve the effective use of advance directive and informed consent; holistic Therapeutic Interventions covering a range of patient-centric, evidence-based approaches; ICU Care with an acute shortage of ventilators, among others; Care for Non-COVID-19 Patients that ensures that care facilities do not discriminate against certain groups or individuals, COVID-19 crisis notwithstanding; health Information Management that supports the autonomy and data privacy of patients in the face of practical imperatives of public health and contact tracing; Research involving non-standard interventions or medication; Healthcare Workers’ Rights and Obligations that balances the value of their safety and well-being and their duty to care; Working Committees that tackle head-on a myriad of seemingly intractable ethical issues in the care of COVID-19 patients; and, Post-mortem Care that takes into account personal and religious preferences. The full document is available here.
The development of the Guidelines is part of a project funded by the Philippine Council of Health Research and Development. Additional funding support is being considered by the Commission of Higher Education. The document is evolving, and further changes may be proposed via upsilab.org/covid-19-ethics where an open collaboration on the Guidelines is encouraged.
