Guidelines give health care professionals a transparent framework for decision making in extreme circumstances
April 13, 2020 (Tallahassee) - After careful and extensive deliberation, the Florida Hospital Association Board of Trustees on April 9 voted to support the Florida Bioethics Network's (FBN) "Ethics Guidelines for Crisis Standards of Care." These guidelines serve as a framework for decision making in the event of an unprecedented critical shortage of life-saving medical devices and treatment alternatives due to the COVID-19 pandemic.
The FBN guidance provides suggestions for the ethical treatment of patients based on a variety of factors that allow successful treatment for the greatest number of patients possible if the number of critically ill patients far exceeds available hospital resources in the state. FBN's guidelines also incorporate guidance and instruction issued March 28 by the Office of Civil Rights within the U.S. Department of Health and Human Services.
"We hope and pray that the worst-case scenario of a surge of COVID-19 hospitalizations does not come to pass," said Crystal Stickle, interim president and CEO, Florida Hospital Association. "Given the exponential and rapid growth of COVID-19 infections and hospitalizations, however, we would be remiss if we did not plan for a scenario where resource availability isn't adequate. Asking our brave and compassionate health care workforce to make decisions about patient care without guidance and help would be a failure of our duty to support them in their essential work."
"Nobody wants this guidance to be needed," said Kenneth W. Goodman, Ph.D., director, Florida Bioethics Network. "But in a crisis situation of this magnitude where resource scarcity is a very real possibility, it would be irresponsible not to support our clinicians with carefully developed, thoughtful, and vetted ethical guidance."
Recognizing the struggles health care workers on the frontlines of this pandemic are experiencing from caring for seriously ill COVID-19 patients, which may number in the hundreds or thousands, nearly 20 other states already have adopted or are in the process of adopting crisis standards of care. In an environment in which the continued availability of all essential resources is uncertain, it is only appropriate to have an ethical framework for difficult conversations and decisions about resource triage.
"The FBN guidelines provide a transparent framework for decision-making grounded in the ethical principles of fairness, equity and accountability," said Stickle. "The magnitude and extremity of circumstances that would have to occur before the FBN guidance is implemented have not been experienced by health care providers in this country for nearly a century. These are measures of last resort that every hospital in the state has been working around the clock to avoid by procuring all available supplies, equipment and resources."
About the Florida Hospital Association
The Florida Hospital Association comprises over 200 hospitals and health systems from across the state. Through representation and advocacy, education and informational services, we support the mission of our members to provide the highest quality of care to the patients we serve. For more information, visit www.fha.org.