Background Duty to care is integral to nursing practice. Personal obligations that normally conflict with professional obligations are likely amplified during a public health emergency such as COVID-19. Organizations can facilitate a nurse’s ability to fulfill the duty to care without compromising on personal obligations. Research Aim The study aimed to explore the relationships among duty to care, perception of supportive environment, perceived stress, and COVID-19-specific anxieties in nurses working directly with COVID-19 patients. Research Design The study design was a cross-sectional descriptive study using an online survey. It was conducted at an ANCC Magnet® designated 385-bed acute care teaching hospital located in a suburban area. Participants and Research Context Included in this study were 339 medical surgical nurses working directly with COVID-19 patients during the early phase of the pandemic. Ethical Considerations The study was reviewed by the institution’s clinical research committee and determined to be exempt. A survey invitation letter with a voluntary implied consent agreement was sent to participants with a description of the research study attached to the anonymous survey. Results Nurses with specific COVID-19-related anxieties were more likely to agree that it was ethical to abandon the workplace during a pandemic. Conclusions Organizations can and ought to mitigate the negative effects of COVID-19 on duty to care in future pandemics and healthcare emergencies by incorporating several recommendations derived from this study.
In light of his experience as clinical bioethicist in a healthcare institution in the U.S.A. (i.e., Anne Arundel Medical Center in Annapolis, MD), Christian Cintron reflects on concrete challenges–from the COVID-19 pandemic to the increasing costs of cancer care for individuals and families–that test the ability of providing care to cancer patients. Hence, policy reforms are urgent. They should aim at transforming practices in prevention and in providing care, while avoiding what he calls “financial toxicity.” The stories of three patients exemplify both the ethical concerns and the needed structural solutions to foster prevention. The equitable participation of cancer patients through solidaristic practices exemplifies one approach leading to systemic improvements.
Reducing disparities in health for racial and ethnic minorities has been a focus for US public health since the Heckler Report. Yet, a majority of racial and ethnic minorities in the US continue to have lower life expectancies and are more susceptible to poorer health outcomes compared to their white counterparts. Improvements in public health have been thwarted by ideological differences and structural restraints that necessitate an alternative method aimed at reorienting ethical discourse and guiding the public health as an institution. Informed by a neo-Aristotelian concept of justice and the good life explicated through the Catholic social tradition, a new framework will enable public health to more wholly achieve its aim in the service of the populations that continue to be marginalized.
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