Part 3 - Triage Decisions, Shared Decision Making and Advanced Care Planning for COVID-19: A Guidance Document for Levels 2 & 3 Health Care Facilities
BACKGROUND
With the unprecedented siege that COVID 19 has taken on our health care system, we are faced with a strain on both human and medical resources. This being, a rational and uniform process of communication regarding goals of care with both patient and family as well as a timely and sensitive triaging system has been seen as imperative. In the same manner, fundamental ethical principles are all the more crucial as we strive to maintain the best care possible patient-centered under the conditions of resource scarcity.
This document may serve as a provisional guidance for the process of shared decision making and triage for intensive-care treatment, the greater part of which has been adapted from existing international guidelines on the ethical framework of critical decision making, advanced care directives and palliative care in the context of this present pandemic. It has been prepared through the collaboration of the Philippines Society of Hospice and Palliative Medicine (PSHPM), the National Hospice and Palliative Care Council of the Philippines (Hospice Philippines Inc.), in consultation with the Philippine Society of Public Health Physicians (PSPHP) and Philippine Alliance of Patient Organization (PAPO) and reviewed by leaders in the Philippine Bioethics Community. As an interim guide, it may be useful to colleagues throughout the country, keeping in mind that it will be updated and expanded, in line with evolving national guidance and contributions from the medical community. The most current version of the guidance document will be available on the public-facing pages of PSHPM and Hospice Philippines.
Our present crisis requires everyone to work together to contribute towards the care of patients and families, especially those who are facing both the physical and psychological distress of COVID-19.