| dc.description.abstract | During the COVID-19 pandemic, evidence-based resources have been sought to support decision-making
and strategically inform hospitals’ policies, procedures, and practices. While greatly emphasizing protection, most guiding documents have neglected to support and protect the psychosocial needs of
frontline health care workers and patients and their families during provision of palliative and end-oflife care. Consequently, the stage has been set for increased anxiety, moral distress, and moral injury
and extreme moral hazard. A family-centered approach to care has been unilaterally relinquished to a
secondary and nonessential role during the current crisis. This phenomenon violates a foundational
public health principle, namely, to apply the least restrictive means to achieve good for the many. Instead,
there has been widespread adoption of utilitarian and paternalistic approaches. In many cases the foundational principles of palliative care have also been neglected. No circumstance, even a global public
health emergency, should ever cause health care providers to deny their ethical obligations and
human commitment to compassion. The lack of responsive protocols for family visitation, particularly
at the end of life, is an important gap in the current recommendations for pandemic triage and contingency planning. A stepwise approach to hospital visitation using a tiered, standardized process for
responding to emerging clinical circumstances and individual patients’ needs should be considered,
following the principle of proportionality. | en_US |
