Palliative Care During Public Health Emergencies: Examples from the COVID-19 Pandemic
UMass Chan Affiliations
Department of Family Medicine and Community HealthDepartment of Medicine, Division of Palliative Care
Document Type
Journal ArticlePublication Date
2020-09-01Keywords
palliative carepublic health
COVID-19 pandemic
primary care
patient wishes
decision making
Family Medicine
Health Services Administration
Infectious Disease
Palliative Care
Primary Care
Telemedicine
Virus Diseases
Metadata
Show full item recordAbstract
In public health emergencies such as the COVID-19 pandemic, some patients—especially older patients or those who have chronic health conditions—are confronted with treatment choices as they face life-threatening illness. Drawing on longitudinal relationships, primary care physicians can help patients and their families reach decisions that best align with patient goals. These crucial conversations may take place under intense pressure. COVID-19, for example, can cause sudden decompensation, leading to abrupt respiratory failure and death. Other factors, including unpredictable clinical courses and resource limitations, may further complicate guiding patients through goal-aligned decision-making. Patients' expressed wishes (e.g., to stay at home no matter what) can conflict with their goals (e.g., to die with minimal discomfort). Dying with severe dyspnea from COVID-19 pneumonia is traumatic and may contribute to complicated grieving and lifelong regret and guilt for caregivers. In addition to relationship-based advance care planning, physicians can use palliative care and ethical principles to develop high-quality crisis care plans that best meet patient needs, even during emergencies.Source
Gracey K, Martin S, Reidy J. Palliative Care During Public Health Emergencies: Examples from the COVID-19 Pandemic. Am Fam Physician. 2020 Sep 1;102(5):312-315. PMID: 32866361. Link to article on publisher site