{"id":73897,"date":"2020-03-31T09:30:15","date_gmt":"2020-03-31T07:30:15","guid":{"rendered":"https:\/\/diaridigital.urv.cat\/?p=73897"},"modified":"2020-05-21T18:57:56","modified_gmt":"2020-05-21T16:57:56","slug":"patients-need-to-be-prioritized-depending-on-whether-their-condition-is-reversible-or-not-but-there-can-be-no-place-for-just-abandoning-people","status":"publish","type":"post","link":"https:\/\/diaridigital.urv.cat\/en\/patients-need-to-be-prioritized-depending-on-whether-their-condition-is-reversible-or-not-but-there-can-be-no-place-for-just-abandoning-people\/","title":{"rendered":"\u201cPatients need to be prioritized depending on whether their condition is reversible or not, but there can be no place for just abandoning people\u201d"},"content":{"rendered":"<p>Professionals working in accident and emergency, intensive care and services that attend to the critically ill are in direct contact with the most unstable patients. They often have to take difficult decisions in emergency situations and when health resources are insufficient to meet the needs of the high number of patients. The need to take these decisions can lead to a phenomenon known as \u2018moral stress\u2019, which is caused by the restrictions that prevent them from doing what they would do in normal circumstances.<\/p>\n<p>In a crisis like the current one, \u201cwe move from the ethics of daily healthcare to a situation in which the parameters that have to be taken into account are much broader and the perspective becomes one of macroethics\u201d, states the dean of the Faculty of Nursing, Mar\u00eda Jim\u00e9nez, who is a specialist in the ambit of healthcare ethics, bioethics and accident and emergency care. For this reason the decisions that are taken \u201cmust be reached by consensus and based on scientific, technical and ethical criteria under an umbrella of protocols that help professionals to take decisions that strike the balance between the resources available and the need for humane healthcare\u201d.<\/p>\n<h5>Triage based on distributive justice<\/h5>\n<aside class=\"perfil_persona\"><a href=\"http:\/\/diaridigital.urv.cat\/wp-content\/uploads\/2020\/03\/maria-jimenez.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-72352 \" src=\"https:\/\/diaridigital.urv.cat\/wp-content\/uploads\/2020\/03\/maria-jimenez-288x300.png\" alt=\"\" width=\"208\" height=\"216\" srcset=\"https:\/\/diaridigital.urv.cat\/wp-content\/uploads\/2020\/03\/maria-jimenez-288x300.png 288w, https:\/\/diaridigital.urv.cat\/wp-content\/uploads\/2020\/03\/maria-jimenez.png 518w\" sizes=\"auto, (max-width: 208px) 100vw, 208px\" \/><\/a>\nMar\u00eda Jim\u00e9nez is dean of the Faculty of Nursing at the URV, a member of the Applied Nursing research group and the PREHOSPEN research group of the University of Boras (Sweden), where she is visiting professor. She is a specialist in the ambit of care ethics, bioethics and accident and emergency care.<\/p>\n<\/aside>\n<p>To tackle these difficulties, the Spanish Society for Intensive and Critical Medicine and Coronary Units, which brings together professionals working in this ambit, has published a protocol regarding the ethical aspects involved in decision taking that is intended to guide the actions of hospital workers during the COVID-19 health emergency. This document states that is legitimate to establish a form of triage that is based on the principle of distributive justice and adds that the criteria must be re-evaluated on a daily basis because it is essential that protocols are not blindly applied without thinking, instead they must allow for fair and transparent decisions to be taken.<\/p>\n<p>Jim\u00e9nez explains that the concept of \u201ctriage\u201d has been misunderstood by the public due to misinformation and the use of inappropriate and belligerent language by public figures: \u201cThis is not a war, it is a public health problem in which resources have been overwhelmed by the demand\u201d, she asserts. For this reason, it is essential to realize that patients are prioritized on the basis of \u201cdistributive justice\u201d, that is, treatment is administered in proportion to the benefit that the patient is likely to receive and according to the extent to which their condition is reversible.<\/p>\n<h5>\u201cNobody should die alone\u201d<\/h5>\n<p>If their condition cannot be reversed, palliative measures must be taken, although Jim\u00e9nez insists that \u201cthere can be no place for just abandoning people\u201d. She also points out \u201cwhether or not there is an emergency, the overriding principle is the duty to provide care, which in the present situation can come under pressure. And it is an ethical care priority that nobody dies alone\u201d. As an example of good practice, she highlights the initiative of hospitals who allow one family member to be confined in the same room with an individual who is reaching the end of their life.<\/p>\n<h5>How is the mental health of health professionals being affected<\/h5>\n<p>In addition to patients and relatives, \u201cthe mental health of professionals must be looked after to prevent them from suffering moral stress and burn out in the form of disillusionment, frustration, or mental health problems induced by situations that can harm professionals\u201d, states Mar\u00eda Jim\u00e9nez. This primarily occurs because of the increased number of ethical decisions that they have to take in highly complex and uncertain situations. It is also due to the fact that \u201cwe are trained to accompany people in serious situations and to make every effort to save their lives, but in much more controlled settings. However, at this moment, we need to match our treatment to scientific evidence that indicates what is and what is not useful for people\u201d.<\/p>\n<p>Consequently, healthcare centres and the health system need to \u201ccare for all their professionals and for our Nursing and Medicine students, who are collaborating in these tasks with real desire to help; we must take every measure not to put them at risk because they are our future\u201d, Jim\u00e9nez advised.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The dean of the Faculty of Nursing, Mar\u00eda Jim\u00e9nez, explains the importance of distributive justice in triage and calls for the mental health of health professionals to be protected given the ethical decisions that they have to take<\/p>\n","protected":false},"author":54,"featured_media":72342,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3474,249,236,818,796],"tags":[4513],"class_list":["post-73897","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nursing","category-faculty-nursing","category-health","category-press-releases","category-pdi-en","tag-coronavirus-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/posts\/73897","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/users\/54"}],"replies":[{"embeddable":true,"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/comments?post=73897"}],"version-history":[{"count":0,"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/posts\/73897\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/media\/72342"}],"wp:attachment":[{"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/media?parent=73897"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/categories?post=73897"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/diaridigital.urv.cat\/en\/wp-json\/wp\/v2\/tags?post=73897"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}