Use of Jonsen's Four Topic Approach in the Treatment Policy of COVID-19-Associated Severe Respiratory Failure under Prolonged Venovenous Extracorporeal Membrane Oxygenation: A Case of Ethical Approach

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  • Yamamoto Mai
    Department of Intensive Care Medicine, Tokyo Women's Medical University
  • Ichiba Shingo
    Department of Intensive Care Medicine, Tokyo Women's Medical University Department of Clinical Engineering, Tokyo Women's Medical University
  • Banzai Sakuko
    Department of Nursing, Tokyo Women's Medical University
  • Hoshino Atsumi
    Department of Intensive Care Medicine, Tokyo Women's Medical University
  • Shimada Masako
    Department of Nursing, Tokyo Women's Medical University
  • Yaguchi Arino
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Nomura Takeshi
    Department of Intensive Care Medicine, Tokyo Women's Medical University

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Other Title
  • 長期VV-ECMO管理中のCOVID-19関連重症呼吸不全患者の治療方針の決定に対してJonsen 4分割表を用いた倫理的アプローチを施行した1例
  • チョウキ VV-ECMO カンリ チュウ ノ COVID-19 カンレン ジュウショウ コキュウ フゼン カンジャ ノ チリョウ ホウシン ノ ケッテイ ニ タイシテ Jonsen 4ブンカツヒョウ オ モチイタ リンリテキ アプローチ オ シコウ シタ 1レイ

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Abstract

<p>Extracorporeal membrane oxygenation (ECMO) has been as a for lifesaving rescue therapy for patients with severe acute respiratory failure associated with coronavirus disease-2019 unresponsive to mechanical ventilation. Although the broad application of this new technology undoubtedly saves lives in many cases, these innovations have created new ethical issues in intensive care medicine. Intensivists managing patients treated with ECMO should be prepared to deal not only with complex clinical management, but also with ethical issues. For the clinical-ethical case analysis, we used the "four-topic" approach described by Jonsen, et al. This method helped classify all aspects of clinical ethics into four categories and provided a framework for linking the current situation of this case to ethical principles.</p>

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