{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:54:07Z","timestamp":1771548847864,"version":"3.50.1"},"reference-count":12,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncology Practice"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p>The coronavirus disease 2019 (COVID-19) pandemic has raised a variety of ethical dilemmas for health care providers. Limited data are available on how a patient\u2019s concomitant cancer diagnosis affected ethical concerns raised during the early stages of the pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We performed a retrospective review of all COVID-related ethics consultations registered in a prospectively collected ethics database at a tertiary cancer center between March 14, 2020, and April 28, 2020. Primary and secondary ethical issues, as well as important contextual factors, were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Twenty-six clinical ethics consultations were performed on 24 patients with cancer (58.3% male; median age, 65.5 years). The most common primary ethical issues were code status (n = 11), obligation to provide nonbeneficial treatment (n = 3), patient autonomy (n = 3), resource allocation (n = 3), and delivery of care wherein the risk to staff might outweigh the potential benefit to the patient (n = 3). An additional nine consultations raised concerns about staff safety in the context of likely nonbeneficial treatment as a secondary issue. Unique contextual issues identified included concerns about public safety for patients requesting discharge against medical advice (n = 3) and difficulties around decision making, especially with regard to code status because of an inability to reach surrogates (n = 3).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION:<\/jats:title><jats:p>During the early pandemic, the care of patients with cancer and COVID-19 spurred a number of ethics consultations, which were largely focused on code status. Most cases also raised concerns about staff safety in the context of limited benefit to patients, a highly unusual scenario at our institution that may have been triggered by critical supply shortages.<\/jats:p><\/jats:sec>","DOI":"10.1200\/op.20.00440","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T19:55:21Z","timestamp":1598558121000},"page":"e369-e376","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":12,"title":["COVID-19\u2013Related Ethics Consultations at a Cancer Center in New York City: A Content Review of Ethics Consultations During the Early Stages of the Pandemic"],"prefix":"10.1200","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-9176","authenticated-orcid":false,"given":"Danielle Novetsky","family":"Friedman","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Pediatrics, Weill Cornell Medical College, New York, NY"},{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3008-5941","authenticated-orcid":false,"given":"Liz","family":"Blackler","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yesne","family":"Alici","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy E.","family":"Scharf","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9949-5036","authenticated-orcid":false,"given":"Martin","family":"Chin","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6840-7988","authenticated-orcid":false,"given":"Sanjay","family":"Chawla","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Anesthesiology, Pain, and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Anesthesiology, Weill Cornell Medical College, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique C.","family":"James","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1291-4611","authenticated-orcid":false,"given":"Louis P.","family":"Voigt","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Anesthesiology, Pain, and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Anesthesiology, Weill Cornell Medical College, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1080\/15265160601109085"},{"key":"B2","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1086\/JCE2016274322","volume":"27","author":"Courtwright A","year":"2016","journal-title":"J Clin Ethics"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2013.000901"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27617"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1177\/1062860608316729"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.7326\/M20-1738"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.5442"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2005689"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb2005114"},{"key":"B13","unstructured":"Berlinger N, Wynia M, Powell T, et al: Guidelines for institutional ethics services responding to the coronavirus pandemic: Managing uncertainty, safeguarding communities, guiding practice, 2020. https:\/\/www.thehastingscenter.org\/ethicalframeworkcovid19"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.09.025"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00960"}],"container-title":["JCO Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/OP.20.00440","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T11:41:52Z","timestamp":1696592512000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/OP.20.00440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1200\/OP.20.00440"],"URL":"https:\/\/doi.org\/10.1200\/op.20.00440","relation":{},"ISSN":["2688-1527","2688-1535"],"issn-type":[{"value":"2688-1527","type":"print"},{"value":"2688-1535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"2020-08-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication 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