ASCO recently released a set of recommendations to support the oncology community as health-care institutions across the United States face potentially difficult decisions around the allocation of scarce health-care resources during the COVID-19 pandemic. In some geographic areas, the ongoing crisis is expected to demand more resources than federal or local health-care systems can supply, and institutions will need to develop allocation decision policies as they provide care for a growing number of patients.
The recommendations state, “ASCO affirms the inherent worth and dignity of each patient affected by cancer and recognizes that cancer is a heterogeneous disease that differs in its prognosis, progression, and treatment for individuals. Allocation decision processes therefore should not unconditionally deny patients with cancer consideration for access to scarce resources.”
The recommendations were developed by the ASCO Ethics Committee, approved by the Board of Directors, and accepted after peer review for future publication in the Journal of Clinical Oncology.
ASCO’s recommendations aim to encourage the development of fair and equitable policies at the health system level for allocation of resources, especially critical care sources, and are not intended to guide individual treatment decisions.
ASCO’s recommendations assert:
- Institutions should develop a fair and consistent prioritization and allocation policy before allocation becomes necessary, and make decisions at an institutional level, rather than at the bedside.
- Allocation of resources in a pandemic should be based on maximizing health benefits. Rationing for life-saving critical care resources should not use assessments about the perceived quality of a patient’s life or perceptions about a patient’s social worth.
- Oncologists should work with their institutions on how best to utilize scarce resources for the care and support of patients with cancer.
- Oncologists should communicate allocation plans and decisions to their patients with compassion and honesty, and health-care institutions should offer support to oncologists in these communications.
- Oncologists should engage in advance care planning discussions with their patients and carefully document patient preferences for goals of care, particularly end-of-life care.
View the full recommendations.
View all of ASCO’s COVID-19 resources.
© 2020. American Society of Clinical Oncology. All rights reserved.
