Management in oncology during COVID-19 pandemic - ethical, legal and health-economic implications

social sciences - Decision making on cancer care during the COVID-19 pandemic is characterized not only by limited resources and prioritizations of acute treatments, but also by multidimensional implications for treatment algorithms, long-term outcomes and clinical process management. This is not restricted to the phase of insufficient availability of resources during the pandemic, but has to be considered during all phases of the pandemic progression: 0) regular treatment before the pandemic; 1) prevention of the spread and preparation for infected individuals; 2) resource scarcity, and 3) of re-establishment of regular treatment routines. The complexity of cancer care requires specific considerations of ethical and medico-legal aspects during the pandemic, but currently such guidelines are only available for intensive/ emergency care. The proposed project aims to develop data-based decisional guidelines for oncology care under the context of pandemics. Stakeholder perspectives will be assessed by specific questionnaires. Clinical data from various sources (clinical cancer registry, claims data), data regarding oncology-specific critical resource availability during pandemic and selected economic data will be used for modelling consequences in terms of morbidity development, and disease-related outcomes. Based on our findings, a comprehensive evaluation of ethical and medico-legal aspects will lead to the development of a checklist for the management of oncology care during the pandemic and to the development of guidelines for this type of decision making under these critical conditions.