FOR IMMEDIATE RELEASE ON May 15, 2020
New Ethical Guidance for Neurologists Caring for Patients During COVID-19 Pandemic
MINNEAPOLIS – The American Academy of Neurology (AAN), the world’s largest association of neurologists with more than 36,000 members, is issuing new ethical guidance for neurologists and neuroscience professionals caring for neurology patients during the COVID-19 pandemic. The new position statement is published in the May 15, 2020, online issue of Neurology®, the medical journal of the American Academy of Neurology. The position statement was developed by the Ethics, Law, and Humanities Committee, a joint committee of the American Academy of Neurology, American Neurological Association, and Child Neurology Society, in collaboration with the Neurocritical Care Society Ethics Committee. The AAN position statement recommends that people with chronic neurologic disease who need to see their neurologist in non-emergency situations should be offered telehealth appointments to limit potential exposure to COVID-19. Some neurologic medications may weaken a person’s immune system, putting them at greater risk of COVID-19. For example, people taking corticosteroids or immunomodulating therapies for multiple sclerosis or myasthenia gravis may be more susceptible to COVID-19. “People should be counseled by their neurologists on how their non-emergency neurologic condition may change their risk of hospitalization and death due to a COVID-19 infection,” said position statement author Michael A. Rubin, M.D., of UT Southwestern Medical Center in Dallas, a Fellow of the American Academy of Neurology and member of the AAN’s Ethics, Law, and Humanities Committee. “Entering a hospital or clinic for a non-emergency may impose a greater risk of infection than normal, even if appropriate precautions are taken.” For patients with neurologic disease severe enough to warrant hospitalization, such as those with stroke or epilepsy, the AAN states that neurologists must still endeavor to maintain the customary standard of care in this complex, new environment. “Now is one of the most challenging times of our careers as neurologists,” said James C. Stevens, M.D., FAAN, President of the American Academy of Neurology. “Clinics and hospitals are adapting to caring for the most ill, managing scarce resources, and trying to protect people without the disease. As neurologists, we must continue to adapt our daily practice, continue to care for our most ill neurology patients, and help contribute to the care of those afflicted with COVID-19.” The AAN also recommends that neurologists work with their patients to complete advance care planning documents. “In the event that hospitals have to triage limited resources, it’s possible that people with advanced neurologic disease may not be offered certain elements of lifesaving care, such as ventilators and ICU beds,” said Rubin. “To ensure more control in the treatments they receive, people with advanced disease and their loved ones should discuss with their neurologist how reduced resources may impact their care and communicate their care preferences if they were to become seriously ill.” When resources are scarce, the position statement lists criteria that should be considered when determining how those resources should be allocated, noting that decisions should be based on need, prospect of benefit, best medical evidence, and the balance of personal freedoms with the interests of the entire community, with the main goal being to maximize the number of lives saved. Learn more about COVID-19 and neurologic disorders at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.