• James N Kirkpatrick, Sarah C Hull, Savitri Fedson, Brendan Mullen, and Sarah J Goodlin.
• Division of Cardiology and Department of Bioethics and Humanities, University of Washington, Seattle, Washington. Electronic address: kirkpatj@uw.edu.
• J. Am. Coll. Cardiol. 2020 Jul 7; 76 (1): 85-92.

AbstractThe COVID-19 pandemic and its sequelae have created scenarios of scarce medical resources, leading to the prospect that health care systems have faced or will face difficult decisions about triage, allocation, and reallocation. These decisions should be guided by ethical principles and values, should not be made before crisis standards have been declared by authorities, and, in most cases, will not be made by bedside clinicians. Do not attempt resuscitation and withholding and withdrawing decisions should be made according to standard determination of medical appropriateness and futility, but there are unique considerations during a pandemic. Transparent and clear communication is crucial, coupled with dedication to provide the best possible care to patients, including palliative care. As medical knowledge about COVID-19 grows, more will be known about prognostic factors that can guide these difficult decisions.Copyright © 2020 American College of Cardiology Foundation. All rights reserved.

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