Aimee Milliken, RN, PhD, a faculty member at the Center for Bioethics, is part of an expert advisory group convened by The Hastings Center to meet the need for a practical resource to support institutional preparedness and supplement public health and clinical practice guidance on COVID-19.

This resource includes an Ethical Framework to structure real-time discussion of significant, foreseeable ethical concerns arising under contingency levels of care and potentially crisis standards of care. It poses practical questions that administrators and clinicians may not yet have considered, and supports real-time reflection and review of policies and processes. It explains three duties of health care leaders during a public health emergency: to plan, safeguard, and guide.

The resource also offers detailed guidelines to help hospital ethics committees and clinical ethics consultation services quickly prepare to support clinicians providing care amid severe resource limitations.

“This practical resource is meant to provide health care organizations, clinicians, and ethicists with guidance for navigating this unprecedented time in our history,” said Aimee Milliken, RN, PhD, a co-author who is a clinical ethicist, nurse scientist, and director of research at Brigham and Women’s Hospital in Boston. “It includes an extensive list of important ethical topics and questions for consideration as response efforts are planned and implemented, with attention to the unique concerns of the bedside clinician. It will be of particular interest to nurses, especially in the critical care environment, who are, and will be, at the front lines of this pandemic.”

The document is available for free on The Hastings Center’s website: Ethical Framework for Health Care Institutions Responding to Novel Coronavirus SARS-CoV-2 (COVID-19) Guidelines for Institutional Ethics Services Responding to COVID-19:Managing Uncertainty, Safeguarding Communities, Guiding Practice.

Originally published March 2020.