AAN position statement: The COVID-19 pandemic and the ethical duties of the neurologist

Michael A Rubin; Richard J Bonnie; Leon Epstein; Claude Hemphill; Matthew Kirschen; Ariane Lewis; Jose I Suarez; Ethics, Law, and Humanities Committee, a joint committee of the American Academy of Neurology, American Neurological Association, and Child Neurology Society; in collaboration with the Neurocritical Care Society Ethics Committee

doi:10.1212/WNL.0000000000009744

AAN position statement: The COVID-19 pandemic and the ethical duties of the neurologist

Neurology. 2020 Jul 28;95(4):167-172. doi: 10.1212/WNL.0000000000009744. Epub 2020 May 15.

Authors

Michael A Rubin¹, Richard J Bonnie², Leon Epstein², Claude Hemphill², Matthew Kirschen², Ariane Lewis², Jose I Suarez²; Ethics, Law, and Humanities Committee, a joint committee of the American Academy of Neurology, American Neurological Association, and Child Neurology Society; in collaboration with the Neurocritical Care Society Ethics Committee

Affiliations

¹ From the Department of Neurology & Neurotherapeutics and Neurological Surgery (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Schools of Law, Medicine, and Public Policy (R.J.B.), University of Virginia, Charlottesville; Department of Pediatrics (L.E.), Northwestern University Feinberg School of Medicine, Chicago, IL; Departments of Neurology and Neurological Surgery (C.H.), University of California, San Francisco; Departments of Anesthesiology, Critical Care Medicine, Pediatrics and Neurology (M.K.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Departments of Neurology and Neurosurgery (A.L.), New York University Langone Medical Center, New York; and Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (J.I.S.), The Johns Hopkins University School of Medicine, Baltimore, MD. Michael.Rubin@utsouthwestern.edu.
² From the Department of Neurology & Neurotherapeutics and Neurological Surgery (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Schools of Law, Medicine, and Public Policy (R.J.B.), University of Virginia, Charlottesville; Department of Pediatrics (L.E.), Northwestern University Feinberg School of Medicine, Chicago, IL; Departments of Neurology and Neurological Surgery (C.H.), University of California, San Francisco; Departments of Anesthesiology, Critical Care Medicine, Pediatrics and Neurology (M.K.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Departments of Neurology and Neurosurgery (A.L.), New York University Langone Medical Center, New York; and Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (J.I.S.), The Johns Hopkins University School of Medicine, Baltimore, MD.

PMID: 32414880
DOI: 10.1212/WNL.0000000000009744

Abstract

Patients, clinicians, and hospitals have undergone monumental changes during the coronavirus disease 2019 (COVID-19) pandemic. This crisis has forced us to consider the obligations that we neurologists have to our individual patients as well as the greater community. By returning to our fundamental understanding of these duties, we can ensure that we are providing the most ethically appropriate contingency and crisis care possible. We recommend specific adaptations to both the inpatient and outpatient settings, as well as changes to medical and trainee education. Furthermore, we explore the daunting but potentially necessary implementation of scare resource allocation protocols. As the pandemic evolves, we will need to adapt continuously to these rapidly changing circumstances and consider both national and regional standards and variation.

MeSH terms

COVID-19
Coronavirus Infections / complications
Coronavirus Infections / therapy*
Health Resources
Humans
Nervous System Diseases / complications
Neurologists / ethics*
Neurology / education
Neurology / ethics*
Pandemics / ethics*
Pneumonia, Viral / complications
Pneumonia, Viral / therapy*
Referral and Consultation
Societies, Medical
Telemedicine