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Experts Discuss Ethical Considerations in Ebola Care

Five points of ethical guidance provided to help clinicians and health care workers

TUESDAY, Dec. 30, 2014 (HealthDay News) -- Guidance is provided for ethical considerations relating to Ebola care in an ideas and opinions piece published online Dec. 30 in the Annals of Internal Medicine.

Scott D. Halpern, M.D., Ph.D., and Ezekiel J. Emanuel, M.D., Ph.D., from the University of Pennsylvania in Philadelphia, address ethical and operational issues related to Ebola and offer five points of guidance.

The authors note that Ebola presents an unfamiliar ethical paradigm for clinicians and hospital administrators; the risks to clinicians should be incorporated into decisions usually predicted on risk-benefit ratios for the patient alone. Any policy about Ebola management should accommodate clinicians' perceptions of the specific circumstances of an individual patient; for example, a default policy of not routinely providing cardiopulmonary resuscitation is preferable to a blanket prohibition. The risks to health care workers providing care for patients with Ebola should be continually measured and reported. Noting that default policies permitting individualized decision-making could lead to discrimination, hospitals should consider establishing an oversight committee to review decisions and intervene if necessary. Institutional default policies and individual clinical decisions should be disclosed to patients and families.

"Given the substantial uncertainty about the prognosis of patients with Ebola cared for in well-resourced intensive care units and the actual risks for transmission of this disease to health care workers in such settings, these recommendations merit updating as new evidence emerges," the authors write.

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