As California prepares for a potential surge of COVID-19, there is a pressing need to determine how critical care resources should be allocated, especially if there is an extreme shortage of those resources. Understanding that these are both important and critical decisions that require thoughtful consideration, the University of California assembled a critical care bioethics team to develop guidance that helps physicians with decision-making if crisis standards of care had to be implemented.
This group recently launched a web-based survey (www.uccovidstudy.com) to gather public input on this topic. "It's important that we get this policy right, and to do that, it must reflect a diversity of viewpoints and values from different communities," said Russell Buhr, MD, PhD, assistant professor of medicine in the division of pulmonary and critical care at the David Geffen School of Medicine at UCLA.
"By engaging people who might be affected by this and getting their feedback, we can refine our policy to include peoples' preferences and concerns."
Through this web-based survey, people can express how they feel health systems and hospitals should allocate resources, as well as how the policy should be communicated to patients and the public. The survey is available in multiple languages.
Hearing from diverse communities is a key objective with this survey. "We need to hear from as many different types of people as possible to better understand how unique subgroups have distinct experiences and opinions," said Lauren Wisk, PhD, assistant professor in the division of general internal medicine and health service research at the David Geffen School of Medicine at UCLA. "Representation is critical and we want to make sure every voice is heard."
While the hope is that our health systems will never reach a point where there are not enough resources for all who need them, it's important to be prepared for this scenario. "These types of scarce resource allocation policies really are the final backstop to ensure that if we can't keep up with the needs for critical care, we have a transparent and equitable way to make medically sound decisions about how to allocate our resources," Buhr said.
