Healthcare Ethics During a Pandemic

Iserson, Kenneth V.

doi:10.5811/westjem.2020.4.47549

Cited by 65 publications

(92 citation statements)

References 20 publications

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“…It seems that at the onset of the COVID-19 outbreak, people (including healthcare providers) exaggerated its associated risk; yet as they became more familiar with the disease, their emotional burden decreased. 10 One could argue that with the exception (perhaps) of military personnel, no person is obliged to respond to life-threatening emergencies. While codes of ethics and professional oaths may guide healthcare providers in addressing these conflicting situations, they do not necessarily require them to respond.…”

Section: Discussionmentioning

confidence: 99%

“…24 Indeed, it is their individual behavior and character, as well as their social and organizational surroundings, that may affect nurses' willingness to respond to such emergencies and the content of such a response. 10,25 Another conflict discussed in this research relates to the question of how to distribute scarce life-saving medical resources given the extensive and imminent need during the COVID-19 pandemic. Studies conducted outside Israel suggest that nurses working with physicians during the COVID-19 outbreak had to make care-provision decisions which have ethical implications.…”

Section: Discussionmentioning

confidence: 99%

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Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

2020

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Background: Positioned at the frontlines of the battle against COVID-19 disease, nurses are at increased risk of contraction, yet as they feel obligated to provide care, they also experience ethical pressure. Research question and objectives: The study examined how Israeli nurses respond to ethical dilemmas and tension during the COVID-19 outbreak, and to what extent this is associated with their perceived risk and motivation to provide care? Research design: The study implemented a descriptive correlative study using a 53-section online questionnaire, including 4 open-ended questions. Participants and research context: The questionnaire was complete by 231 registered and intern nurses after being posted on nurses’ Facebook and WhatsApp groups, and through snowball sampling. Ethical considerations: The research was pre-approved by the ethics committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa, Israel. Findings: In all, 68.8% of the respondents had received some form of training about COVID-19. Respondents positioned themselves at perceived high risk levels for contracting the virus. About one-third feared going to work because of potential contraction and due to feeling inadequately protected. While 40.9% were scared to care for COVID-19 patients, 74.7% did not believe they have the right to refuse to treat certain patients. When asked about defining an age limit for providing patients with scarce resources (such as ventilation machines) in cases of insufficient supplies, respondents stated that the maximum age in such scenarios should be 84 (standard deviation (SD = 19) – yet most respondents (81.4%) believed that every patient has the right to receive optimal treatment, regardless of their age and medical background. Discussion: Correlating with their strong commitment to care, nurses did not convey intention to leave the profession despite their stress, perceived risk, and feelings of insufficient support and protection at work. The nurses did not hold a utilitarian approach to resource allocation, thereby acknowledging the value of all people and their entitlement to care, regardless of optimal outcomes. Conclusion: While experiencing significant personal risk and emotional burden, nurses conveyed strong dedication to providing care, and did not regret working in the nursing profession, yet they did seek a supportive climate for their needs and ethical concerns.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

2020

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“…In addition, there was an incredible increase in patients not transported to hospitals and the number of patients who died at home (Figure 1, Panel A and B, respectively). The increased number of patients not transported to hospitals maybe reflects an excessive request by the people who called without a real need, but it could also mean an ineluctable "selection" of the patients due to overcrowding of the reference hospitals (17,18). Indeed, hospitals were unable to accommodate all the patients requiring healthcare.…”

Section: Discussionmentioning

confidence: 99%

The Lombardy Emergency Medical System Faced with COVID-19: The Impact of Out-of-Hospital Outbreak

Fagoni¹,

Perone²,

Villa³

et al. 2020

Prehospital Emergency Care

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Objective: The Lombardy region was among the areas most affected by COVID-19 infection worldwide; the Lombardy Emergency Medical System (EMS) responded immediately to this emergency. We analyzed several critical aspects to understand what occurred in that region. Methods: This retrospective study compares the events managed by the dispatch center and the characteristics of the patients transported to the hospital-age, sex, SpO 2 , deaths-managed by the EMS in Brescia and Bergamo provinces between March-April 2020 and March-April 2019. Ambulances' waiting time at the hospitals before discharging patients and the patients' severity at emergency department admission were also analyzed. Results: EMS managed 37,340 events in March-April 2020, þ51.5% versus 2019. "Breathing" or "Infective" events reported to the dispatch center increased more than tenfold (OR 25.1, p < 0.0001) in March 2020 and twofold in April 2020 compared to 2019 (OR 3, p < 0.0001). Deaths increased þ246% (OR 1.7, p < 0.0001), and patients not transported to hospital þ481% (OR 2.9, p < 0.0001) in March 2020 compared

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“…2 In disaster situations, although most healthcare professionals will want to respond, whether they actually do so, and then continue to do so, depends on the risk they perceive to themselves and their families, the measures being taken to keep them safe, the value they see in their work, the completeness and transparency of the information they are given about the developing situation, and their personal (professional, religious, and other) values. 3,4 Once healthcare professionals decide to stay, their numbers will inevitably decrease due to the vast influx of patients and the expanded roles they must perform, leading to burnout, as well as to illness-related attrition, especially in epidemics. For example, 14% of Spain's first 40,000 confirmed coronavirus cases were medical professionals.…”

Section: University Of Arizona Department Of Emergency Medicine Tucmentioning

confidence: 99%

Augmenting the Disaster Healthcare Workforce

Iserson

2020

WestJEM

Self Cite

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IsersonAugmenting the Disaster Healthcare Workforce better and longer. Specifically, ask them to rest whenever possible, hydrate frequently, eat often but generally avoid simple sugars and caffeine, and get exercise. 38 CONCLUSIONIn disasters such as the COVID-19 pandemic, we need to use all available resources to bolster our healthcare workforce. Many factors go into this process, including selecting the groups of professionals we will need, streamlining their licensing and credentialing processes, identifying appropriate roles for them, and supporting their health and well-being.

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Healthcare Ethics During a Pandemic

Cited by 65 publications

References 20 publications

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

The Lombardy Emergency Medical System Faced with COVID-19: The Impact of Out-of-Hospital Outbreak

Augmenting the Disaster Healthcare Workforce

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