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Prioritization and Resource Allocation in the Context of the COVID-19 Pandemic. Recommendations for Colorectal and Pancreatic Cancer in Germany

ONCOLOGY RESEARCH AND TREATMENT(2024)

Ruhr Univ Bochum | Institute for History and Ethics of Medicine | Univ Hosp Bonn | Ulm Univ | Staedt Klinikum Karlsruhe | Hosp Boeblingen | Tech Univ Dresden | Sudharz Klinikum Nordhausen | Heidelberg Univ | Department of Gynecology and Obstetrics | Klinikum Aschaffenburg | Goethe Univ Frankfurt | Arbeitskreis Pankreatektomierten AdP eV | Deutsch ILCO eV | Profess Assoc Resident Gastroenterologists BNG | Univ Hosp Halle Saale | Assoc German Tumor Ctr | Ctr Hematol & Oncol Bethanien | Department of Hematology and Oncology with Palliative Care | St Josefs Hosp Wiesbaden | Ludwig Maximilians Univ Munchen | Heinrich Heine Univ | Charite Univ Med Berlin | Krankenhaus Barmerzige Brueder Regensburg | Martin Luther Univ Halle Wittenberg | Jena Univ Hosp | German Canc Soc | Section Translational Medical Ethics | Hannover Med Sch

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Abstract
In the context of the COVID-19 pandemic, there has been a scarcity of resources with various effects on the care of cancer patients. This paper provides an English summary of a German guideline on prioritization and resource allocation for colorectal and pancreatic cancer in the context of the pandemic. Based on a selective literature review as well as empirical and ethical analyses, the research team of the CancerCOVID Consortium drafted recommendations for prioritizing diagnostic and treatment measures for both entities. The final version of the guideline received consent from the executive boards of nine societies of the Association of Scientific Medical Societies in Germany (AWMF), 20 further professional organizations and 22 other experts from various disciplines as well as patient representatives. The guiding principle for the prioritization of decisions is the minimization of harm. Prioritization decisions to fulfill this overall goal should be guided by 1. the urgency relevant to avoid or reduce harm; 2. the likelihood of success of the diagnostic or therapeutic measure advised; and 3. the availability of alternative treatment options. In the event of a relevant risk of harm as a result of prioritization, these decisions should be made by means of a team approach. Gender, age, disability, ethnicity, origin and other social characteristics, such as social or insurance status, as well as the vehemence of a patient’s treatment request and SARS-CoV-2 vaccination status should not be used as prioritization criteria. The guideline provides concrete recommendations for 1. diagnostic procedures, 2. surgical procedures for cancer, and 3. systemic treatment and radiotherapy in patients with colorectal or pancreatic cancer within the context of the German healthcare system.
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Resource allocation,Colorectal cancer,Guideline,Pandemic,Pancreatic cancer
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要点】:本文提供了在COVID-19大流行背景下,德国针对结直肠癌和胰腺癌患者进行资源分配和优先级设定的指南,以最小化对患者造成的伤害。

方法】:研究团队基于选择性文献回顾、实证和伦理分析,制定了一套优先级设定和资源分配的推荐方案。

实验】:该指南通过多个医学专业组织和专家的审核,未提及具体实验,但基于广泛的跨学科合作和共识,提出具体诊断、手术和系统治疗建议,适用于德国医疗体系。