The covid pandemic has put up many important issues related to the human race. The necessity to survive, access to food and day to day living norms. This essay will address the options health care workers ( HCW) have in relating issues of dilemmas, doubts and violence they face.
It will elaborate and justify why health care workers ought to refuse the care they provide.The novel SARS-Cov virus and the disease it causes, Cov‐19, is currently impacting every part of daily life. It is one of the most unpredictable global public health crises in recent times, and according to the Center for Disease Control and Prevention, COVID‐19 is contagious and deadly, disproportionately affecting the elderly,children and those with chronic underlying disease (Center for Disease Control and Prevention, 2020).
An ethical dilemma is a choosing between two decisions based on differential professional norms; both may be on moral values( Gilbert 2019).According to Christopher Cheney, there are few ethical dilemmas considering the treatment of COVID;related to treatment of COVID patients when they are admitted in hospitals,obligation for care when doctors and nurses have to provide care despite of being at risk to catch the contamination and availability and utilization of medicines which are available in scanty numbers. It can also be refusing to pursue the duty in case the situation is inevitable or harmful to the worker itself.
The medical practitioners and doctors have turned out to be heroes in this fight. Many of them have lost their lives and many have not seen their families yet. In this situation, where the lives of people matter, there are many ethical issues about what is to be done and what not. It is not only important to the lives of the population but also the lives of doctors and workers who are at most vulnerable.
When it comes to clinicals and doctors treating covid patients, the most risky part is to be effected from the virus by the patients. It is no doubt the duty of the doctors to treat the patients. The health workers face this dilemma. The concerns are raised among the doctors and health workers. The possibility of their family being contracted by the disease when they return home after a day’s work. The duty that is performed by the health workers are justifiable because it comes under the norms of the oath they take. The other side of the coin is doing good for the community as benefaction. The present scenario has shown how mean humans can be. The workers have faced fear and anger of the affected patients. But constant rise in maltreatment of the doctors and nurses can allow them to take their steps back.
If the health workers are themselves affected with any sort of respiratory symptoms whose exposure might cause problems in the workplace and society.In this situation it becomes mandatory for the worker to stay in isolation informing the health care centres. The call of duty is important and is at highest priority. But the one who is infected is not supposed to come in contact with others. It is to avoid the growth of corona infection. It is never acceptable for a medical worker to act in a way which poses harm to the community. The people who are engaged in taking care of the infected patients must also take care of their health. Awareness is important among the workers. They must save themselves first so that they can save others and serve the community. It becomes mandatory for the health worker to refuse service. The worker can do it to save himself and the community in other ways as well. (Menon & Padhy 2020).
The lack of PPE kits puts the life of the doctors at risk. It is inevitable to say that they have all rights to refuse to treat the covid patients. Many doctors and nurses have succumbed to death due to the lack of kits. The time and situation must be thankful to any health care professional who are willing to care for COVID19 patients without thinking about themselves.But if one find that availability of PPE kits or other important equipment are not enough or less than required, there is no reason to take the health professional for granted that they would be there for service (Schuklenk 2020).
Thus, doctors and health workers have autonomy to refuse to treat. It can put a risk to their own life. The proper availability of kits, masks and gloves are mandatory to stop contraction of disease. The graduation ceremonies of the doctors are held where they take a public oath to serve the people’s good. It is a modern-day Hippocratic Oath where doctors promise to provide emergency care and treatment without any if or but. According to Ariel R Schwartz, ‘the history of medical ethics reveals that the medical workers cannot come to an agreement on the nature and scope of its responsibilities during an epidemic’. The response towards the individual is different from one to another. Some run away to save themselves and their families whereas some stay and treat the patients. This pattern was observed in the Ebola outbreak in African countries and also in the plague in the 17th and 18th century. It can be concluded that the autonomy of decision rests with the doctor or the medical practitioner whether he should do it or not regardless of the oath.
With the emergence of pandemic, there have been so many casualties that hospitals are not able to cope with the number of beds to the number of patients. Many are refused to be admitted in the hospitals. Lack of monitoring devices as compared to the number of patients is vast. In that case a question that arises in the mind. Should the critical patients be given the machinery support who have almost no chance to survive or the ones who have better chances to recover? Subsequently the health workers find themselves in the situation of ethical dilemma. They are forced to go through unpleasant situations where they have to choose within the scanty resources that whom to prioritize while giving the resources.
Taking the emotional account of physicians of the non governmental medical professional organization, it is noted that doctors were compelled to make choices in favor of the patient who has the best chance of surviving. Ethically and lawfully it is not acceptable but situations tend to become such that no other options are to be taken in consideration.
There are moral obligations regarding the medical implications. Again it is visualized that conflict occurs. Who are in the utmost necessity to receive the medicine. The one who is severely ill and has non chance of recovery or the one who is better and can recover easily. The confusion here comes here in a humanitarian way. The health workers( doctors and nurses) have to decide on their own what needs to be done in the particular situation.
Many of the news have circulated regarding the violence and misbehaviour against the doctors treating the patients. The incidence of spitting on the health workers, not following the rules of maintaining distance and not following the norms of wearing masks and proper covering of the body. Even the nurses have been facing instances where the particular section of people have shown gestures that are unacceptable. There were incidents where it was circulated that some of the patients belonging to a particular religion,spat on them while being taken by the nurses.
They were further trolled,traumatized,cliche comments were passed on them. The nurses were on their duty. The duty of taking care and providing health services to the covid patients irrespective of their race, caste or religion.In this case the health workers have all rights to refuse the treatment. The moral obligations become a hindrance here as self care is the first priority. The doctors themselves have to be fine to cure others.These incidents not only break the moral of health workers but also leave a message for the people. The consensus of the health workers to follow the duty is important as well as their health management is vital from an individual perspective
A lot of ethical issues can be solved by being mindful and with scientific assessment like the which resources should be provided to a severe ill patient;decisions can also be taken based on organizational decorums and government policies.The health workers (nurses and doctors) have to weigh the advantages and disadvantages whether they should turn up for work. If they face any symptoms of the disease, it is the individual's responsibility not to be a carrier for others. . The health professionals are bound by the duty of taking care of patients in all kinds of unavoidable situations. Working and carrying out the duty with limited resources available,continuing to perform the medical operations definitely puts them at risk but it is solely their call to decide their action. It can be hence concluded that refusing to treat or care patients is acceptable if it concerns the health of the doctor or the nurse themselves.
Center for Disease Control and Prevention. (2020). Coronavirus (COVID‐19). Center for Disease Control and Prevention. Retrieved from https://www.cdc.gov/coronavirus/2019‐ncov/index.html [Accessed 30 Aug. 2020]
Cheney, C.( 2020). 4 ethical dilemmas for healthcare organizations during the covid-19pandemic.[ Online]available from https://www.healthleadersmedia.com/clinical-care/4-ethical-dilemmas-
Healthcare-organizations-during-covid-19-pandemic [Accessed 30 Aug. 2020].
Menon, V., & Padhy, S. K.(2020). Ethical dilemmas faced by health care workers during COVID-19 pandemic: Issues, implications and suggestions. Asian journal of psychiatry, 51, 102116. https://doi.org/10.1016/j.ajp.2020.102116 [Accessed 30 Aug. 2020]
Gilbert, N (2019). Ethical Dilemmas in Social Work Practice.What You Need to Know.
[Online]available from https://www.noodle.com/articles/ethical-dilemmas-in-social-work-what-to-
Know-about-nasw-code-of-ethics [Accessed 30 Aug. 2020].
Schuklenk, U. (2020). What healthcare professionals owe us: why their duty to treat during a pandemic is contingent on personal protective equipment (PPE). Journal of Medical Ethics, p.medethics-2020-106278 [Accessed 30 Aug. 2020]
Schwartz, A.R. (2007). Doubtful Duty: Physicians’ Legal Obligation to Treat during an Epidemic. Stanford Law Review, [online] 60(2), pp.657–694. Available at: https://www.jstor.com/stable/40040419 [Accessed 30 Aug. 2020].
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