The Covid-19 pandemic in Mexico: The fundamental role of palliative care and bioethics
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Published:
Jan 4, 2021
Keywords:
Pandemic, COVID-19, Palliative care, bioethics, support
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Abstract
The Covid-19 pandemic has tested all health systems. The crisis that it caused has affected society, the economy, and, in general, all human activities. Palliative care and bioethics play a fundamental role in the management of the new Covid-19 disease that does not yet have a known treatment. The principles of bioethics, coupled with the practice of palliative care have supported the pandemic. Patients who have recovered and those who have died as a result of Covid-19 have at some point required support and palliative measures, either in hospital units or at home. It is desirable to promote these tools: palliation and ethics of life, since not only from technology come the solutions that allow taking care of life and health, and they should not be mutually exclusive. One year after the start of the pandemic, there are still many questions to be answered, and much research to be done. Undoubtedly, the year 2020 will give a reason for reflection to all human beings and especially to those responsible for taking care of health.
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Llaca Gracía, E., & Templos, L. A. (2021). The Covid-19 pandemic in Mexico: The fundamental role of palliative care and bioethics. Medicina Y Ética, 32(1), 179–195. https://doi.org/10.36105/mye.2021v32n1.05
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2020; 24: 91-8. https://doi.org/10.1016/j.jare.2020.03.005
2. Yan R, Zhang Y, Li Y, Xia L, Guo Y, Zhou Q. Structural basis for the recognition
of Sars-CoV-2 by full-length human ACE2. Science (80). 2020; 367(6485): 1444-8.
https://doi.org/10.1126/science.abb2762
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4. Emanuele Nicastri NP, Bartoli TA, Luciana Lepore AM, Fabrizio Palmieri GD,
Luisa Marchioni SM, Giuseppe Ippolito AA. National Institute for the Infectious
Diseases «L. Spallanzani», IRCCS. Recommendations for Covid-19 clinical management.
Infect Dis Rep. 2020; 12: 8543. https://doi.org/10.4081/idr.2020.8543
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Arch Oncol. 2002; 10(1): 29-31.
6. González C, Méndez J, Romero JI, Bustamante J, Castro R, Jiménez M. Cuidados
paliativos en México. Palliative care in Mexico. Rev Med Hosp Gen Méx.
2012; 75(3): 173-9.
7. Covarrubias Gómez A, Otero Lamas DM, Templos Esteban DLA, Soto Pérez
de Celis E, Internacional G. Educación continua en cuidados paliativos. 2019;
42(2): 122-8.
8. Del Río MI, Palma A. Cuidados paliativos: historia y desarrollo. Boletín Esc
Med UC, Pontificia Univ. Católica Chile. 2007; 32(1): 16-22. Recuperado en: http://
cuidadospaliativos.org/uploads/2013/10/historia de CP.pdf
9. Radbruch L, De Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, et al. Redefining
palliative care. A new consensus-based definition. J Pain Symptom Manage.
2020. Recuperado en: https://doi.org/10.1016/j.jpainsymman.2020.04.027
10. Feder SL, Akgün KM, Schulman-Green D. Palliative care strategies offer guidance
to clinicians and comfort for covid-19 patient and families. Hear Lung. 2020;
49(3): 227-8. https://doi.org/10.1016/j.hrtlng.2020.04.001
11. Powell VD, Silveira MJ. What should palliative care’s response be to the Covid-
19 pandemic? J Pain Symptom Manage. 2020; 60(1): e1-3. https://doi.org/10.
1016/j.jpainsymman.2020.03.013
12. Hernández MACO, Rujillo ALFE. La soledat dels pacients amb Covid-19 al final
de les seves. Revista de Bioética y Derecho Perspectivas Bioéticas. 2020;
5887(c): 81-98. https://doi.org/10.1344/rbd2020.50.31683
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(10231): 1168. http://dx.doi.org/10.1016/S0140-6736 (20)30822-9
14. Reich WT. Encyclopedia of bioethics. New York; London: Macmillan Pub. Co.
Simon & Schuster Macmillan/Prentice Hall International; 1995.
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mundo y cambió para siempre el concepto de muerte TT. 50 years after the first
heart transplant: the operation that stunned the world and forever changed the
concept of death. Rev chil cardiol. 2017; 36(3): 275-82. Recuperado en: http://
www.scielo.cl/scielo.php?script=sci_arttext&pid=S0718-85602017000 300275
https://doi.org/10.4067/s0718-85602017000300275
16. Pellegrino ED. Bioethics and politics: «Doing ethics» in the public square. J
Med Philos. 2006; 31(6): 569-84.
17. Hernández Medina MS. Overview of the overweight and obesity epidemic in
Mexico. Panorama de la epidemia de sobrepeso y obesidad en México. 2020;
8(16): 65-71.
18. Wynne KJ, Petrova M, Coghlan R. Dying individuals and suffering populations:
Applying a population-level bioethics lens to palliative care in humanitarian contexts:
Before, during and after the Covid-19 pandemic. J Med Ethics. 2020; 46(8):
514-25. https://doi.org/10.1136/medethics-2019-105943
19. Fried TR, Bradley EH, Towle VR, Allore H. Understanding the treatment preferences
of seriously ill patients. N Engl J Med. 2002; 346(14): 1061-6.
https://doi.org/10.1056/nejmsa012528
20. Kirchhoffer DG. Dignity, autonomy, and allocation of scarce medical resources
During Covid-19. J Bioeth Inq. 2020. https://doi.org/10.1007/s11673-020-09 998-3
21. Biondo CA, Da Silva MJP, Secco LMD. Dysthanasia, euthanasia, orthotanasia:
the perceptions of nurses working in intensive care units and care implications.
Rev Lat Am Enfermagem. 2009; 17(5): 613-9. https://doi.org/10.1590/s0104-1169
2009000500003
22. Pérez Pérez FM. Adecuación del esfuerzo terapéutico, una estrategia al final
de la vida. The suitability of therapeutic effort: An end-of-life strategy. Semergen.
2016; 42(8): 566-74. Recuperado en: www.elsevier.es/semergen
https://doi.org/10.1016/j.semerg.2015.11.006
23. Wallace CL, Wladkowski SP, Gibson A, White P. Grief During the Covid-19
pandemic: Considerations for palliative care providers. J Pain Symptom Manage.
2020; 60(1): e70-6. https://doi.org/10.1016/j.jpainsymman.2020.04.012
24. Reilly MAO. Effective Difficult Conversations: A Step-by-step guide. In review:
Effective difficult conversations. 2020; 26(1). https://doi.org/10.5860/rusq.56.4.297a
25. Xia H, Zhang W, Tu C, Kang L, Wu W, Qu Z, et al. Development of predictive
nomogram for ICU mortality in severe Covid-19. SSRN Electron J. 2020.
https://doi.org/10.2139/ssrn.3627282
26. Silva DS. Ventilators by lottery: the least unjust form of allocation in the coronavirus
disease 2019 pandemic. Chest. 2020; 158(3): 890-1. https://doi.org/10.1016/j.chest.2020.04.049
27. Powell T, Bellin E, Ehrlich AR. Older Adults and Covid-19: The most vulnerable,
the hardest hit. Hastings Cent Rep. 2020; 50(3): 61-3. https://doi.org/10.1002/
hast.1136
28. Johnson SB. Advancing global health equity in the Covid-19 response: beyond
solidarity. J Bioeth Inq. 2020 (April).
29. Robinson S, Kissane DW, Brooker J, Burney S. A Review of the construct of
demoralization: history, definitions, and future directions for palliative care. Am J
Hosp Palliat Med. 2016; 33(1): 93-101. https://doi.org/10.1177/1049909114553461
30. Riisfeldt TD. Weakening the ethical distinction between euthanasia, palliative
opioid use and palliative sedation. J Med Ethics. 2019; 45(2): 125-30.
https://doi.org/10.1136/medethics-2018-105074