No room for patients or ethics: COVID-19-broken hospitals in Madrid

In 2020, COVID-19 patients overwhelmed hospital beds in several Spanish cities, producing an increase in mortality derived from a lack of resources. The provision of new spaces to be reconfigured as healthcare centers for COVID patients was one of the measures implemented. In Madrid, two of these COVID centers drew enormous media and political repercussions due to their high cost and the controversy surrounding the quality of the care they offered. In this scenario of misinformation, several doctors and patients rejected to be transferred to such medical centers, but they were nonetheless compelled to make the move. This manuscript underscores how this lack of transparency affects health workers, patients, and the relationship between them, and brings out the question of how many essential bioethical principles can be individually violated by a matter of public health. New guidelines for the transfer of patients should be designed from an ethical perspective and updated, as the epidemic continues, to improve the modern understanding of human factors in times of uncertainty. The lesson that these centers provide us is that we must rethink crisis resource management from a new perspective that prioritizes access to quality information. In its absence, the principle of autonomy must prevail.