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American College of Surgeons: 3 guidelines to alleviate physicians' 'moral distress'

The COVID-19 pandemic is causing "significant moral distress" among surgeons, whose duty to patients is now in conflict with public health needs, according to the American College of Surgeons.

To help, the ACS shared ethical considerations for medical decisions during the crisis:

1. With elective procedure bans in effect across the country, surgeons can consult ACS guidelines for prioritizing cases.

"Although rationing may be the ultimate effect of having limited resources, prioritizing and triaging are probably more acceptable terms in less severe circumstances. In truth, the intensity of the term being used may well depend on the degree of shortage any individual institution is facing," ACS said.

2. Surgeons may be tempted to continue performing elective procedures, fearing delays could cause poor long-term outcomes, patient frustration and financial distress.

"Health systems and federal and state governments should begin developing comprehensive solutions to address the financial impact on hospitals, physicians, and other healthcare providers that result from canceled operations, so that these perceived financial risks do not influence some surgeons to continue to perform elective operations," ACS recommended.

3. COVID-19 resources and guidelines are constantly in flux. Every organization should convene a surgical review committee to provide "defined, transparent and responsive oversight," ACS said. "This committee can lead the development and implementation of guidelines that are fair, transparent and equitable."

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