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Ethical Criteria for the Admission and Management of Patients in the ICU Under Conditions of Limited Medical Resources: A Shared International Proposal in View of the COVID-19 Pandemic

2020 , Tambone, Vittoradolfo , Boudreau, Donald , Ciccozzi, Massimo , Sanders, Karen , Campanozzi, Laura Leondina , Wathuta, Jane , Violante, Luciano , Cauda, Roberto , Petrini, Carlo , Abbate, Antonio , Alloni, Rossana , Argemí Ballbé, Josepmaría , Argemí Renom, Josep , Benedictis, Anna De , Galerneau, France , Munive García, Carlos Emilio , Giampaolo Ghilardi , Palmer Hafler, Janet , Linden, Magdalena , Marcos, Alfredo , Onetti Muda, Andrea , Pandolfi, Marco , Pelaccia, Thierry , Picozzi, Mario , Revello, Ruben Oscar , Ricci, Giovanna , Rohrbaugh, Robert , Rossi, Patrizio , Sirignano, Ascanio , Spagnolo, Antonio Gioacchino , Stammers, Trevor , Velázquez, Lourdes , Mercurio, Mark , Agazzi, Evandro

The present pandemic has exposed us to unprecedented challenges that need to be addressed not just for the current state, but also for possible future similar occurrences. It is worth pointing out that discussions on the allocation of medical resources may not necessarily refer to an exception, but, unfortunately, to a regular condition for a large part of humanity (1). The criteria for admission to an Intensive Care Unit (ICU) setting generally take into account multiple factors. There must be a diagnostic and prognostic basis for the decisions made, considering both biological factors and patient values and wishes. Furthermore, the decision-making process should, whenever possible, respect the patient's advance directives as well as the relationship with the patient's family or attorney. Therapeutic neglect should be avoided. Having applied standard clinical evaluation criteria for the appropriate treatment of patients with COVID-19, including consideration of prognosis, if a hospital then finds itself unable to provide optimal treatment (e.g., due to a disproportion between the number of patients and the availability of beds, healthcare providers, ventilators, and drugs in the ICU), it becomes necessary to evaluate, case by case, how to achieve justice and the best possible good for the greatest number of patients. It is therefore mandatory to explore alternative solutions; these include increasing available beds and healthcare providers, implementing alternative, though suboptimal, approaches (where appropriate), transferring patients to other clinical units, etc. Making these decisions properly also involves the recovery of the political role of medicine and science © Frontiers in Public Health

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Personal attitudes and denialist views about the COVID-19 pandemic in Italy: a national survey

2022 , Sisto, Antonella , Quintiliani, Livia , Vicinanza, Flavia , Fabris, Silvia , Campanozzi, Laura Leondina , Curcio, Giuseppe , Michilli, Mirta , Molina, Alfonso , Ghilardi, Giampaolo , Manazza, Andrea , Lauri, Gaetano , Gentile, Rocco , Perciaccante, Antonio , De Micco, Francesco , Navarini, Luca , Velázquez, Lourdes , Picozzi, Mario , Ricci, Giovanna , Piacquadio, Flora , Maioni, Melissa , Ermili, Fabio , Tambone, Mario , Chelucci, Gian Luca , Ciccozzi, Massimo , Tambone, Vittoradolfo

Since COVID-19 began to spread, hypotheses about the possible causes of the disease and its treatment have increased worldwide, engenedering fears and concerns. This context of uncertainty, as well as the great changes that people were forced to accept in their daily lives, have challenged the general population, affecting public opinion and collective imagination inevitably, with also a negative impact on compliance with public health policies. This study explored the personal attitudes towards the COVID-19 pandemic and their association with denial stances in the Italian context. The aim was to address the relevance of these phenomena and in what guise they are present in relation to the grounds supporting them, as an avenue to be more effective in public health under different domains. An online questionnaires was set out to survey the general population over 18 throughout the Italian country, including students and health professionals, to offer geographic and professional diversity. General population was also stratified based on their direct or indirect experience of COVID-19, whilst health participants were recruited with regard to their involvement in a COVID centre. A total of 2110 questionnaire were filled out between December 2020 and April 2021. Of the participants, 85.45% completely disagree with the possibility that COVID-19 is not real and that the cultural, social and economic system wanted us to believe otherwise, whereas 69% had doubts about what has been claimed to date about the existence of COVID-19. Trust in institutions and types of COVID-19 experience affected these beliefs. The results also show that stress, anxiety, sadness, and vulnerability increased as compared to the pre-COVID- 19 pandemic timeframe. The fundings of this national survey revealed how much behaviors based on social responsibility and rational prudence are important for defensing human life. ©Medicina e Morale