Ethics in the use of prognostic scores in intensive care units: an integrative review

Authors

Abstract

Facing COVID-19 caused many problems in the healthcare field, due to the rise in the intensive care demand. To solve this crisis, caused by the scarcity of resources of high complexity, decision-making has been guided by prognostic scores; however, this process includes a moral dimension, although less evident. With na integrative review, this article sought to reflect on the reasonability of using severity indicators to define the allocation of the scarce resources in healthcare. We observed that the work carried out on resource scarcity situations causes moral overload, converging to the search for
standard and objective solutions, such as the use of prognostic scores. We conclude that their isolated and indiscriminate use is not ethically acceptable and deserves cautious evaluation, even in emergency situations, such as COVID-19.

Keywords:

COVID-19. Ethics. Organ dysfunction scores. Apache. Uncertainty. Bioethics. Healthcare rationing.

Author Biographies

Roberta Nascimento de Oliveira Lemos dos Santos, Escola Nacional de Saúde Pública Sergio Arouca - Fiocruz

Roberta Lemos dos Santos –  Doutora em Bioética, Ética Aplicada e Saúde Coletiva na Escola Nacional de Saúde Pública Sergio Arouca ENSP/Fiocruz. Pós doutorado em curso pelo programa de Pós graduação em Bioética, Ética Aplicada e Saúde Coletiva.

Luciana Stoimenoff Brito, Anis – Instituto de Bioética

Doutora em Ciências da Saúde, Pesquisadora da Anis – Instituto de Bioética, pós-doutorado em curso no Programa de Pós-graduação em Bioética, ética aplicada e saúde coletiva da UFRJ, Fiocruz, UFF e UERJ.  Brasília, DF, Brasil

Sergio Tavares de Almeida Rego, Escola Nacional de Saúde Pública - ENSP/Fiocruz

Doutor em Saúde Coletiva, Pesquisador titular na Fiocruz, professor permanente no Programa de Pós-graduação em Bioética, ética aplicada e saúde coletiva da UFRJ, Fiocruz, UFF e UERJ. ORCID: , Rio de Janeiro, RJ, Brasil.

How to Cite

1.
Lemos dos Santos RN de O, Brito LS, Rego ST de A. Ethics in the use of prognostic scores in intensive care units: an integrative review. Rev. bioét.(Impr.). [Internet]. 2022 Jul. 6 [cited 2024 May 10];30(2). Available from: http://revistabioetica.cfm.org.br/revista_bioetica/article/view/2906