Development of a Regional Consensus Statement on Ethical Practices in the Treatment of Ebola Virus Disease for Hospitals and Health Systems

Background/Purpose

We describe a community-based collaborative process in a large Midwestern region to develop a consensus statement on ethical practices in the treatment of Ebola Virus Disease (EVD) for hospitals.

Method

As a result of the EVD outbreak in West Africa and several instances of cases in the United States, hospitals across the world initiated plans and processes to identify and treat suspected cases. Hospitals planning to treat patients with EVD faced built environment constraints (e.g., lack of adequately sized anterooms in ICUs) and challenges working in and with PPE leading to tough ethical questions about which treatments (e.g., cardiac resuscitation) may be possible and which could not be performed safely. The fragmented nature of this decision making posed a threat to area hospitals as some might be perceived as providing ‘better’ care than others. Leveraging an existing emergency management healthcare coalition to convene the hospitals, and a strong bioethics center at a major university to lead the process, the hospital systems agreed to develop a consensus ethical framework defining parameters for EVD care.

Results/Outcomes /Conclusions

Ethics officers, legal staff, and clinicians met over two months to develop consensus on a major ethical framework and policies that could be adopted by each constituent hospital.  The consensus recommendation was provided to the healthcare coalition, which then published and encouraged adoption among the facilities, providing a universal framework for EVD response and treatment in the region. The facilitated discussion process also reinforced the strong commitment to collaboration and partnership around emergency management issues.