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The Covid-19 pandemic has been characterized by many unknowns, chief among them in the world of pediatric ethics is the question of separating mothers who are infected or suspected of being infected from their newborns after delivery to reduce the risk of mother-to-child transmission. Guidance on this issue is conflicting.
BIOETHICS FORUM ESSAY
The Covid-19 pandemic has imposed tremendous risk on doctors, nurses, and other health care workers not seen in a century. It is time to reconsider prioritization of health care workers’ access to scare critical resources.
Historically, for multiple reasons, health care workers have not been prioritized for access to medical care during a pandemic. However, given the unprecedented circumstances surrounding the Covid-19 pandemic, it is justifiable to prioritize health care workers when all else is equal between two patients.
As Covid-19 continues to spread throughout the United States, doctors, nurses, and oth-er clinicians are facing unmistakable tragedies. But something less perceptible is afoot. Empathy in medicine is under siege.
Despite the disruptive changes to my undergraduate medical ethics class this semester, my students have learned a lot about the paradox that the coronavirus presents: it is an unprecedented event, beyond the experience of nearly everyone alive today, and yet it puts on grim display the well-known problems of inequality that chronically plague the United States. Since week six of the semester, I have readjusted each unit on the syllabus to address some of the ethical issues that Covid-19 has brought to the fore, familiar challenges that have been stressed and distorted in astonishing ways by the pandemic.
Around the world, governments are looking for safe ways to lift unprecedented restrictions on public activities to curb the spread of Covid-19. So-called immunity passports could be key to the effort to selectively ease restrictions for people presumed to be immune to the virus. But there are scientific and ethical questions to be worked out before they can be deployed.
Dilemmas that clinicians face in the coronavirus pandemic–who gets the ventilator, the 80-year-old grandmother or the 20-year-old student?–are the bread and butter of mainstream bioethics. In medical school, my classmates and I memorized the four principles (beneficence, nonmaleficence, justice, and autonomy), which we were told would help us make hard clinical decisions in ethically ambiguous terrain. But Covid-19 shows that medical ethics means much more than what generally falls under bioethics. Medical ethics is deeply political, and to act ethically in medicine means engaging the larger context in which it operates.
There is little doubt about the urgent need for Covid-19 treatment. But premature publication of definitive recommendations based on inappropriate conclusions grounded in scant, hastily-acquired data serve only at best to confuse and at worst mislead at a time when tensions are high and need for help is great.
Double-blind randomized clinical trials are the gold standard for answering the scientific question of whether a drug produces any effect, positive or negative, in Covid-19 patients. But is rational for a patient to choose to try a drug such as chloroquine for Covid-19 outside of a trial? Some patients may correctly hold that they have little to lose.
As the world reels from the Covid-19 pandemic, two things have become very clear: the health impacts of the disease are devastating, but the aggressive social distancing policies currently being used to flatten the curve also have serious costs. As a result, the question of when and how to reopen the nation is on everyone’s mind. Do we open quickly in an effort to kick-start the economy? Or do we remain under lockdown as long as possible to stop the spread of the virus?
Congregational rituals of religious communities around the world have attracted attention for their possible threat of spreading the coronavirus. Negative Media coverage has generally depicted members of religious communities as more or less “reckless” groups whose “fanatic” convictions can make them harm others from inside or outside their religious traditions. However, what hasn’t been discussed is how this issue should be approached as a complex bioethical issue that concerns people worldwide. With the beginning of Ramadan, paying attention to the nuances and complexities of this issue becomes especially pressing.
The Covid-19 outbreak has forced health care providers, administrative officials, and the general public to each play their part in doing no harm to others. It may come as a surprise to many people, but health care workers may unknowingly spread Covid-19 in their communities simply by wearing scrubs in public.