Ethical guidelines on cardiopulmonary resuscitation in the context of the COVID-19 pandemic in Colombia

Biomedica. 2020 Oct 30;40(Supl. 2):180-187. doi: 10.7705/biomedica.5762.
[Article in En, Spanish]

Abstract

The pandemic caused by COVID19 is associated with an increase in the number of cases of cardiorespiratory arrest, which has resulted in ethical concerns regarding the enforceability of cardiopulmonary resuscitation, as well as the conditions to carry it out. The risk of aerosol transmission and the clinical uncertainties about the efficacy, the potential sequelae, and the circumstances that could justify limiting this procedure during the pandemic have multiplied the ethical doubts on how to proceed in these cases. Based on ethical and legal grounds, this paper offers a practical guide on how to proceed in the clinical setting in cases of cardiopulmonary arrest during the pandemic. The criteria of justice, benefit, no harm, respect for autonomy, precaution, integrity, and transparency are asserted in an organized and practical framework for decision-making regarding cardiopulmonary resuscitation.

La pandemia de COVID-19 se ha asociado con un incremento en el número de casos de paro cardiorrespiratorio y con ello han aumentado las inquietudes éticas en torno a la exigencia de la reanimación cardiopulmonar, así como sobre las condiciones para realizarla. El riesgo de contagio por aerosoles y las incertidumbres clínicas sobre la eficacia, las potenciales secuelas y las circunstancias que podrían justificar la limitación del procedimiento durante la pandemia, han multiplicado las dudas éticas sobre cómo proceder en estos casos. Con base en fundamentos éticos y jurídicos, en el presente artículo se ofrece una guía práctica sobre cómo proceder en los casos de paro cardiopulmonar en el contexto de la pandemia. Los criterios de justicia, beneficio, no daño, respeto a la autonomía, precaución, integridad y transparencia, se presentan de forma organizada y práctica para la adopción de decisiones en materia de reanimación cardiopulmonar.

Keywords: Coronavirus infections; cardiopulmonary resuscitation; codes of ethics; practice guideline.

Publication types

  • Review

MeSH terms

  • Advance Directives
  • Aerosols
  • Air Microbiology
  • Betacoronavirus*
  • Cardiopulmonary Resuscitation / ethics*
  • Cardiopulmonary Resuscitation / methods
  • Clinical Decision-Making
  • Colombia / epidemiology
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / transmission
  • Heart Arrest / etiology
  • Heart Arrest / therapy*
  • Humans
  • Infection Control / methods
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Medical Futility
  • Occupational Exposure
  • Pandemics* / prevention & control
  • Personal Autonomy
  • Personal Protective Equipment
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / transmission
  • Practice Guidelines as Topic*
  • Social Justice

Substances

  • Aerosols

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2