Treating the SARS‐CoV‐2–positive patient with cancer: A proposal for a pragmatic and transparent ethical process

Perni, Subha; Milligan, Michael G.; Saraf, Anurag; Vivenzio, Todd; Marques, Amy; Baker, Meghan A.; Kosak, Tara; Bartlett, Sarah; Physic, Michelle A.; Batchelder, Monica R.; McBride, Sean; Bredfeldt, Jeremy; Cail, Daniel W.; Kearney, Meghan C.; Whitehouse, Colleen; Orio, Peter; Walsh, Gerard; Haas‐Kogan, Daphne A.; Martin, Neil E.

The treatment of patients with cancer who test positive for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) poses unique challenges. In this commentary, the authors describe the ethical rationale and implementation details for the creation of a novel, multidisciplinary treatment prioritization committee, including physicians, frontline staff, an ethicist, and an infectious disease expert. Organizational obligations to health care workers also are discussed. The treatment prioritization committee sets a threshold of acceptable harm to patients from decreased cancer control that is justified to reduce risk to staff. The creation of an ethical, consistent, and transparent decision‐making process involving such frontline stakeholders is essential as departments across the country are faced with decisions regarding the treatment of SARS‐CoV‐2–positive patients with cancer.