Care in the time of coronavirus: Ethical considerations in head and neck oncology

Head Neck. 2020 Jul;42(7):1519-1525. doi: 10.1002/hed.26272. Epub 2020 May 21.

Abstract

As COVID-19 continues to challenge the practice of head and neck oncology, clinicians are forced to make new decisions in the setting of the pandemic that impact the safety of their patients, their institutions, and themselves. The difficulty inherent in these decisions is compounded by potentially serious ramifications to the welfare of patients and health-care staff, amid a scarcity of data on which to base informed choices. This paper explores the risks of COVID-19 incurred while striving to uphold the standard of care in head and neck oncology. The ethical problems are assessed from the perspective of the patient with cancer, health-care provider, and other patients within the health-care system. While no single management algorithm for head and neck cancer can be universally implemented, a detailed examination of these issues is necessary to formulate ethically sound treatment strategies.

Keywords: COVID-19; cancer; ethics; head and neck; oncology.

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Clinical Decision-Making / ethics
  • Coronavirus Infections / prevention & control*
  • Coronavirus Infections / transmission
  • Disease Transmission, Infectious / prevention & control
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Infection Control
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Medical Oncology / ethics*
  • Occupational Health / ethics
  • Pandemics / prevention & control*
  • Patient Care Planning
  • Patient Safety
  • Personal Protective Equipment
  • Physician's Role
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / transmission
  • Resource Allocation
  • SARS-CoV-2
  • Standard of Care
  • Uncertainty