58 Bioethics support in a tertiary children's hospital during the COVID-19 pandemic. (30th November 2020)

• Record Type: Journal Article
• Authors: Aylett, Sarah; MacNiven, Anne; Dittborn, Mariana; Archard, Dave; Linthicum, James; Larcher, Vic; brierley, Joe
• Is Part Of: Archives of disease in childhood. Volume 105(2020)Supplement 2
• Page Start: A20
• Page End: A20
• Publication Date: 2020-11-30
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2020-gosh.58
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : During a pandemic, ethical concerns arise in relation to allocation of resources for seriously ill patients. The COVID-19 pandemic predominantly affected adults with a high associated morbidity and mortality, however it was anticipated that there would also be an impact on the paediatric population. There were four phases to the work of the Paediatric Bioethics Centre (PBC) service at GOSH: 1.Preparation: Documents to support/guide hospital teams and regional inpatient, community and hospice settings were prepared with colleague. We adapted existing 'ethics support' mechanisms to combat workforce moral distress, distress/injury. 2.Bioethics activity: was highest in the rapid response service where difficult treatment decisions were considered with clinical teams, families and young people. 12 reviews were carried out from March- May to consider experimental antiviral treatment, allocation of resources in the context of COVID-19 and non Covid cases considering a ceiling of treatment. Telemedicine facilitated the rapid response to these urgent cases and involved parents, including those not in the hospital. 3.Education: the service provided 'pandemic webcasts' on decision-making and broader child-health concerns. Staff support with other wellbeing services has been essential, especially for those deployed to overwhelmed local adult ICUs. 4. Reflection: focussed on (a) Research Re future deployment to minimise moral distress/injury, b) remote video-conferencing – parents/participants experience/ability to consider complex ethical issues and c) role of faith/non-faith in society's recovery. This work illustrates the importance of the role of the Paediatric Bioethics Service in a tertiary children's hospital during the COVID-19 pandemic.