Challenges in Discussing Life-Sustaining Treatment During COVID-19 Pandemic

Pediatric critical care fellow Michael Certo, MD, MM, has written about the challenges faced by intensivists when communicating remotely—due to pandemic-imposed restrictions—with family members and care givers of critically ill patients. He focused on the inherent subjectivity of certain terms that may lead to misinterpretation and confusion in his article ‘Quality of Life? Suffering? Covid-19 Intensifies Longstanding Challenges in Discussing Life-Sustaining Treatment,’ which was published in the Hastings Bioethics Forum on July 7, 2021.

“Medicine is rife with subjective terminology, and it is incumbent upon us as clinicians to remember that everyday terms like ‘suffering’ and ‘quality of life’ require careful context and specificity to avoid misunderstandings between patients or family members and the medical team,” said Dr. Certo, who is a third-year fellow in the pediatric critical care medicine fellowship program of UPMC Children’s Hospital of Pittsburgh.

He added that, “Life-altering discussions via telephone or video conference resulted in diminished nonverbal communication and eye contact, and eliminated the simple benefit of having another person physically nearby in a time of crisis. Covid-19 simultaneously expanded the distance and constricted the time over which these conversations had to occur.”

Dr. Certo is an MA candidate in Bioethics at the University of Pittsburgh. He completed his residency in Pediatrics at UPMC Children’s Hospital of Pittsburgh and is a medical graduate from Columbia University Vagelos College of Physicians and Surgeons.