Elective cardiovascular care in the era of the COVID-19 pandemic: managing tragic choices

BMJ Open Qual. 2020 Sep;9(3):e001069. doi: 10.1136/bmjoq-2020-001069.

Abstract

The COVID-19 pandemic has led to significant morbidity and mortality globally. As health systems grapple with caring for patients affected with COVID-19, cardiovascular procedures that are deemed 'elective' have been postponed. Guidelines concerning which cardiac procedures should be performed during the pandemic vary by specialty and geography in the USA. We propose a clinical heuristic to guide individual physicians and governing bodies in their decision making regarding which cardiac procedures should be performed during the COVID-19 pandemic using the behavioural economics concept of heuristics and ecological rationality.

Keywords: clinical; decision making; decision support; ethics; health equity; health policy.

MeSH terms

  • Betacoronavirus
  • COVID-19
  • Cardiovascular Surgical Procedures / psychology*
  • Clinical Decision-Making / methods*
  • Contraindications, Procedure
  • Coronavirus Infections / prevention & control*
  • Economics, Behavioral*
  • Elective Surgical Procedures / psychology*
  • Heuristics*
  • Humans
  • Pandemics / prevention & control*
  • Pneumonia, Viral / prevention & control*
  • SARS-CoV-2
  • United States