Introduction by Joseph A. Bosco III, MD, FAAOS, President, American Academy of Orthopaedic Surgeons
As the COVID-19 pandemic continues to evolve, orthopaedic surgeons may be faced with difficult patient care decisions. Specifically, the rapid influx of COVID-19 patients may exceed the health system's capacity to provide care. This is a case where finite resources are inadequate to meet demand. Such scenarios call for the rationing of care.
Rationing requires withholding treatment from certain individuals so that others may be treated. Although new to orthopaedic surgeons, the ethics and system of rationing has been long practiced by our organ transplant colleagues. The guiding principles are:
- Decisions must be made by an individual or individuals familiar with medical ethics and not directly involved in the care of the patient in question
- The algorithms used must be applied equally to all individuals and must adhere to the principals of fairness and justice
Below, Casey J. Humbyrd, MD, FAAOS, hosts the recorded webinar "Public Health Ethics During a Pandemic: What Every Orthopaedic Surgeon Needs to Know" sponsored by the American Orthopaedic Foot & Ankle Society. This webinar provides further detail and practical suggestions for those faced with difficult decisions surrounding rationing of care.
Dr. Humbyrd is Chief of the Foot and Ankle Division and Associate Professor of Orthopaedic Surgery at the Johns Hopkins School of Medicine. She is a member of the AAOS Committee on Ethics and Outside Interests, and is a nationally recognized expert in bio-ethics. Her financial disclosure can be found here. Dr. Humbyrd has also generously offered to answer any questions you may have regarding specific bio-ethical issues. She can be reached via email at: OrthoEthics@gmail.com