Palliative Care During Public Health Emergencies: Examples from the COVID-19 Pandemic
Department of Medicine, Division of Palliative Care; Department of Family Medicine and Community Health
Family Medicine | Health Services Administration | Infectious Disease | Palliative Care | Primary Care | Telemedicine | Virus Diseases
In public health emergencies such as the COVID-19 pandemic, some patients—especially older patients or those who have chronic health conditions—are confronted with treatment choices as they face life-threatening illness. Drawing on longitudinal relationships, primary care physicians can help patients and their families reach decisions that best align with patient goals. These crucial conversations may take place under intense pressure. COVID-19, for example, can cause sudden decompensation, leading to abrupt respiratory failure and death. Other factors, including unpredictable clinical courses and resource limitations, may further complicate guiding patients through goal-aligned decision-making.
Patients' expressed wishes (e.g., to stay at home no matter what) can conflict with their goals (e.g., to die with minimal discomfort). Dying with severe dyspnea from COVID-19 pneumonia is traumatic and may contribute to complicated grieving and lifelong regret and guilt for caregivers. In addition to relationship-based advance care planning, physicians can use palliative care and ethical principles to develop high-quality crisis care plans that best meet patient needs, even during emergencies.
palliative care, public health, COVID-19 pandemic, primary care, patient wishes, decision making
Gracey K, Martin S, Reidy J. Palliative Care During Public Health Emergencies: Examples from the COVID-19 Pandemic. Am Fam Physician. 2020 Sep 1;102(5):312-315. PMID: 32866361. Link to article on publisher site
American family physician
Gracey K, Martin SA, Reidy J. (2020). Palliative Care During Public Health Emergencies: Examples from the COVID-19 Pandemic. COVID-19 Publications by UMMS Authors. Retrieved from https://escholarship.umassmed.edu/covid19/109