Palliative care—which focuses on supporting people with serious or terminal illness or those nearing death—has an important role to play during humanitarian crises such as the coronavirus pandemic. But health professionals need more guidance in how to fairly provide such care in situations where resources are scarce, according to a new essay co-authored by Keona Wynne, a doctoral student in the Population Health Sciences program at Harvard University.
The essay, published June 19, 2020 in the Journal of Medical Ethics, noted that a 2018 guide from the World Health Organization on the use of palliative care during humanitarian crises focused largely on providing care for individual patients. The authors argue for considering palliative care more broadly—through a population-level bioethics lens, which focuses on highlighting and finding solutions for health inequities between and among populations. Using this approach could help address complex moral dilemmas and take into account how longstanding inequalities, discrimination, and power imbalances can influence how palliative care is provided, according to the authors.
The essay outlined various ethical concerns and dilemmas around the provision of palliative care, including the rationing of scarce resources such as ventilators and pain medications. The authors also discussed the question of whether euthanasia should be considered as part of palliative care in certain situations.