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COVID-19 Bioethics: Combatting a Lack of Resources
- Project Medify
- Aug 19, 2020
- 5 min read
By Isha Shrivastava
Abstract
A term coined in 1926, bioethics studies the ethical issues which arise from the advances society makes in the realms of science and medicine. Such issues relate philosophies of biotechnology, politics, law, and religion as well. As this field can be narrowed down to morals, it can also be expanded to the overall science of life; however, the line between right or wrong remains blurry.
In the midst of the COVID-19 pandemic, there are many uninsured people who are seeking healthcare due to critical illness. A surge of patients can lead to the disruption of the ethical processes of patient care, especially as medical institutions and healthcare workers are not equipped with the resources to assimilate to this surge. To aggrandize this public health crisis, there may not exist enough new guidelines in place to adhere to or previous cases and examples to learn from.
Bioethics delves into ethical issues that result from developments in the fields of science and medicine. Such issues are complex and involve biotechnology, politics, law, and religion as well. As this field can be narrowed down to morals, yet also expanded to the overall science of life, there is no definite “right” or “wrong.” Acting ethically is the foundation of healthcare professionalism. In fact, the study of bioethics was deepened in response to the violation of basic human rights in medical research in Europe during World War II. Since then, healthcare workers focus on protecting individual rights as well as curing their patients.
The COVID-19 pandemic is pushing the topic of bioethics to the surface as medical practices are no longer able to be done alongside the comforts known as time and resources. The current public health emergency has led to many families seeking general healthcare, as well as an onslaught of seriously ill patients. This can disrupt ethical patient care in all types of institutions as healthcare workers do not have adequate resources to fight the surge of incoming individuals who are asking for help. During the earlier stages of COVID, at the beginning of the year, medical facilities would have been at conventional capacity— an ordinary rate of use of resources. At this point, the health of the general public didn’t clash with caring for patients affected by other diseases.
However, as the number of cases increased exponentially, hospitals and clinics went from conventional capacity to contingency capacity, finally reaching crisis capacity. Now, with the standard code of ethics put into question by a huge lack of supplies, professionals all around the world are raising concerns regarding discrimination, privacy, and individual freedoms. They are forced to make extremely difficult split-second decisions in emergency rooms, their minds fighting a battle between their duties to respect patients and their duties to benefit society and promote equity. Be mindful that the responsibility of such duties may add more undue emotional stress, guilt and anxiety to the health care providers, which may affect them adversely.
According to The Hastings Center, “Public health practice aims to promote the health of the population by minimizing morbidity and mortality through the prudent use of resources and strategies,” which means, during such crises, healthcare systems seek to prioritize what is best for the public. From this, policies, such as social distancing, are put in place in order to reduce possible encounters between infected people. Of course, this can have varying negative effects on individuals—ranging from a drop in social skills to unemployment—but the overall intention is to lessen the burden on healthcare institutions and further promote good for the community.
Even so, such decisions are challenging to make. As it is the first time a pandemic of this degree has arisen in modern society, there are no set safety guidelines and procedures for healthcare workers to go by. A new disease means uncertainty regarding symptoms and diagnosis, meaning not only doctors and nurses, but ambulance, cafeteria, X-ray, laboratory, radiology techs, EMT, and janitorial staff, had to stay alert for any signs of sickness. Hospitals have had to take measures against the spread of disease inside the building, which led to limitations on matters such as pregnancy visits, cancer treatments, and much more. Even rapid responses against the spread of disease were different around the world. Governments introduced various containment measures such as screening, testing, and individual quarantine, as well as closure of public establishments, and healthcare workers must abide by state and country guidelines while keeping medical training in mind.
Thus, the efforts behind such decisions should follow consequentialism.
Based on the research of Dr. Georgina Campelia from the UWSOM Department of Bioethics & Humanities, “One version of consequentialism that is often used in public health emergencies is utilitarianism, which seeks the greatest good for the greatest number of people,” which aims to lower the danger presented to the entire community. This becomes more complicated when others’ mindsets and values are accounted for. Dr. Campelia wrote, “For instance, how should we evaluate the quantity and/or quality of life in a triage algorithm, when these things are understood and valued very differently by individuals and communities in our society?” which then highlights the potential bias an authoritative decision-making figure could have—and the influence such bias could have on the people who aren’t included in the decision-making process. Consequently, when faced with an inequality such as a lack of ventilators, it should be the main priority to create a policy that offers the greatest benefit to the most underprivileged. If this goes against the goal of increasing lives saved, then ways to resolve the inequality should be reconsidered.
These are all challenging questions, and it is reasonable for people to disagree when discussing them. The key is that utilitarian or consequentialist methods aren’t enough towards responding to pandemic situations. There are more questions to ask and more pressure will be put on each and every person’s morals and virtues. Standard ethical responsibilities are of utmost importance. Healthcare systems have to rely on kindness, respect, and other moral principles to care for others; however, these ethical obligations must be factored into the bigger picture first.
Sources
Brazg, Tracy, et al. “Pandemics.” Pandemics | UW Department of Bioethics & Humanities, 6
Campelia, Georgina. “Slides_Covid-19_Ethics_Intro.” Google Slides, Google, 2020,
“COVID-19 Ethics Resource Center.” Journal of Ethics | American Medical Association,
American Medical Association, 2020, journalofethics.ama-assn.org/covid-19-ethics-resource
Ravitsky, Vardit. “Post-Covid Bioethics.” The Hastings Center, 21 May 2020,
The Hastings Center. “Ethical Framework for Health Care Institutions & Guidelines for
Institutional Ethics Services Responding to the Coronavirus Pandemic.” The Hastings
Center, 2020, www.thehastingscenter.org/ethicalframeworkcovid19/.
Varshavski, Mikhail. “100+ Doctors Tell You the Truth About Battling COVID-19.” Medical
News and Free CME Online, MedpageToday, 15 Apr. 2020,
William C. Shiel Jr., MD. “Definition of Patient Autonomy.” MedicineNet, MedicineNet, 25 Jan.
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