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Out now: Our paper on "State Government Crisis Standards of Care Guidelines: Implications for Patients with Cancer" https://ja.ma/3oqa2tO via @JAMAOnc of @JAMANetwork
Kudos to our @DanaFarber @DanaFarberNews team for their hard work on this, led by Dr Andrew Hantel
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Kudos to our @DanaFarber @DanaFarberNews team for their hard work on this, led by Dr Andrew Hantel
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2/ Notably, this work examines several of the really challenging issues we've been grappling with during the #COVID pandemic, including #ethics of resource scarcity, disability rights & #Ableism, impact of COVID on pts w #cancer, & equity
#Medtwitter #oncoalert #covidncancer
#Medtwitter #oncoalert #covidncancer
3/ We looked at crisis standards of care (CSC) that were publicly available at time of analysis (so findings would be different if you re-analyzed this today!) to see how patients w #cancer are considered in policies re: scarce resource allocation https://ja.ma/3oqa2tO
4/ There was great debate in the spring about CSCs, particularly how they considered (or potentially discriminated against) those with medical comorbidities/disabilities, including cancer. Notably, @ASCO @ASCO_pubs provided guidance about this generally: https://twitter.com/JonMarronMD/status/1255526540688928768?s=20
5/ In our analysis, we found that CSCs varied widely in what scarce resources they addressed and how they proposed to allocate them
Notably, 65% of CSCs explicitly addressed the rights of persons w disabilities, and 77% deprioritized or excluded some pts w comorbidities
Notably, 65% of CSCs explicitly addressed the rights of persons w disabilities, and 77% deprioritized or excluded some pts w comorbidities
6/ Re: #Cancer, 55% of states w available CSCs explicitly deprioritized at least some pts w cancer & 26% categorically excluded some pts w cancer from scarce resources
Notably, many states have revised their CSCs since this time, but this is certainly problematic nonetheless!
Notably, many states have revised their CSCs since this time, but this is certainly problematic nonetheless!
7/ So what?
COVID has brought to light many unjust & inequitable ways we consider those w less access, fewer resources, & medical problems/disabilities. This is one further example of this problem
A #cancer diagnosis alone shouldnt limit a patient's access to scarce resources
COVID has brought to light many unjust & inequitable ways we consider those w less access, fewer resources, & medical problems/disabilities. This is one further example of this problem
A #cancer diagnosis alone shouldnt limit a patient's access to scarce resources
8/ Allocation decisions should be made via sound ethically- & clinically-driven decisions, ideally via well-established, data-driven protocols
As #COVID19 cases rise & we may be forced to allocate resources, this will (again) be very important...
/fin https://ja.ma/3gbExRh
As #COVID19 cases rise & we may be forced to allocate resources, this will (again) be very important...
/fin https://ja.ma/3gbExRh
