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Health Care Ethics

Introduction to Healthcare Workers and Covid-19 Patients

The pandemic, COVID-19 is affecting people at social, economic and political sphere worldwide. The pandemic has shaped surprising challenges for healthcare workers (HCW) all over the globe. Despite of all the challenges, healthcare institutions respond by providing legal, medical, and social aid to the people (Kramer et al.,2020). It is the fundamental and ethical responsibility of HCW to provide quality care to patients. The infection spreads to thousands of people more than the available medical resources. The situation is creating enormous impact on mental and personal health of healthcare workers (Solnica et al.,2020). Although, healthcare workers have to remain calm in tough situations as they are the primary care providers during the current COVID-19 pandemic. COVID-19 is creating issues regarding medical ethics for healthcare providers. The conditions put HCW in dilemmas as they require providing care to patients, taking care of their families and their own personal health as well. The associated health risk raise a question for HCW to provide treatment to COVID-19 patients (Kemparaj et al.,2018).This essay sheds light on the moral obligations of healthcare workers to treat COVID-19 patients for effective care.

Ethical Background of Healthcare Workers

Every healthcare worker has to work within a moral and ethical framework. They abide to a fundamental duty which revolves around minimizing patients’ pain and suffering. It has been guided by an ethical structure that focuses on patient improvement by adapting quality care measures (NMBA, 2020). The nursing and midwifery association preset a code of ethical values in patient favor. It aims to respect the dignity of patients and nurses are responsible and accountable throughout treatment process of patient (NMBA,2020).Although these bio-ethics do not consider beneficence for obligation of compulsion by healthcare workers to provide care during COVID-19 pandemic, the argument favors the HCW to consider their personal thought while providing care to COVID-19 patients with the associated personal risk and to their family members as well. Hence, the essay argument cannot set a strict scope for HCW, considering their ethical and moral principles.

Autonomy

The COVID-19 pandemic has raised various ethical challengesregarding healthcare practice. Pandemic reshape the priorities for patient care at an individual and organizational level as well. The prime principle of medical ethics aims to allow the patient to take decisions regarding their medical care. HCW, while imparting information to the patients, should keep the final treatment call on the patient (Bakewell et al.,2020). However, providing care during a pandemic maximizes the riskfor the doctors and other medical workers as well. The situation is different in the COVID-19 pandemic compared to otherpandemicowing to the fact of rapid spread and virulence of the disease (Barrett et al.,2019). Moreover, it makes impossible to ensure a reduced spread of infection or minimized virulence as well. In such situation the bio-ethical principle of autonomy directly impacts HCW and their personal safety. In this argument, the ethical principle of autonomy is not being acknowledged by the healthcare workers . The doctors and nurses need to protect themselves from the associated risk leading to disobeying their ethical principle (Morrison et al.,2019).

The condition of COVID-19 cannot be compared with HIV pandemic where the spread of the infection was self-controlled. In HIV-pandemic all the healthcare institutions made it compulsory to provide healthcare services to the patients. The same cannot be applicable in COVID-19 pandemic where the mortality rate is significantly high and therefore the HCW have all the rights to decide whether to provide care services or their for their personal safety and care as well (Schuklenk,2020).

Non-Maleficence

The COVID-19 pandemic is molding the ethical and medical priorities of HCW. The medical ethics which aims to provide quality care has been a part of their professional duty. The principle of non-maleficence stands to cause no harm to the patient based on favorable dimensions. The associated health risk in a pandemic to the healthcare workers can force them to disobey the principle of non-maleficence (Smith& Silva,2015). Healthcare workers might refuse to provide care to the infected patients during a pandemic. The associated risk is not limited to the medical worker but link with their family as well due to the contagious nature of the disease (Morrison et al.,2019).In case of less medical resources including gloves, masks, the HCW can refuse to provide quality care as self-protection and care is an important factor(Bakewell et al.,2020). The proper use of essential personal protective equipment is the sole way of personal safety until vaccine development. It supports providingprimary protection against the harmful infection. In the situations where PPE are not available, it has been argued that HCW will not abide to the principle of non-maleficence considering themoral responsibilities for their family (Orentlicher,2018). The principle of non-maleficence should be considered for the safety of both the patients and healthcare worker.

After stepping in the medical profession obeying the principle ethics has been made compulsory for HCW. Moreover, associated risk to HCW during a pandemic has reshaped the ethical principles of the healthcare services. PPE which is an important element in pandemic owing primary personal care, arguing on the fact that healthcare workers must provide care to the patients even by risking their own health. The primary reason for not providing care during COVID-19 pandemic is shortage of PPEs (Orentlicher,2018). It must be considered that the safety of doctor and other medical workers should also be considered. The healthcare organizations must provide all the essential resources to avoid the shortage of effective care by HCW (Kadish, &Loike 2020). In practical terms, the pandemic situation has awoken HCW that they can never stay true towards their ethical patients (Smith& Silva,2015).The shortage of personal care resources make them to rethink regarding their ethical duties and the practical possibilities of their services. Akin, nothing definite can be said in terms of COVID-19 pandemic and its possible outcomes.

Justice

The ethics of justice lies on the fact of accessibility to adequate resources to the patients. The principle of attaining equal resources depends on the availability of the medical resources. During pandemic the availability of resources specifically PPE is essential for provide care to the COVID-19 patients(Smith & Silva,2015). In case of fewer resources it becomes difficult for the HCW to decide to provide care or refuse to the principle of justice. In this argument, the becomes difficult to choose and decide who should be preferred for the provision of treatment (Orentlicher, 2018). The violation of ethic of autonomy during pandemic is mainly owing to resources unavailability. Healthcare workers and medical organizations, both should be held responsible for breaching the ethics of justice. The government ought to actively participate to make available all the essential resources including PPEs to avoid evident cancellation of ethics of justice. The argument marks a note on the Hippocratic ethical approach, and believes, despite ethical principles, the autonomy and justice ought to be applied to HCW in deciding whether they want to risk their life for patient care and safety (Kramer et al.,2020).Healthcare workers and associated risk in pandemic should set them free from completion of medical services. Moreover, the government should amplify their concern for HCW by supplying essential resources.

Beneficence

The idea of ethic of beneficence believes to "do well" or "no harm" to others.The primary ethical oath of healthcare workers to provide quality care to the patients and think about patient welfare (Kemparaj et al.,2018). The primary consideration of HCW ought to work for patient interest.Although, the pandemic conditions reshaped the ethic of beneficence in healthcare organizations. The argument tries to evaluate the right of HCW to decide to risk their life during pandemic for patient safety. The pandemic has jeopardized HCW and medical systems due to patient overload worldwide. Doctors have to focus on patient care by avoiding harm to them. Healthcare workers work for patient safety despite lack of resources like PPEs. The ethics of beneficence of providing no harm to the patient must include self-harm as well.Choice must be made by HCW instead of the strict ethical rules for providing care to the COVID-19 patients. The associated health risk from the corona virus is deadly with respect to high mortality and therefore, the ethical and moral beliefs must be inadmissible. This argument also falls under the Hippocratic four ethical principles of doing no harm to other people (Kadish et al., 2020). Certain changes should be introduced in the ethical values within the jurisdiction framework and ought to consider that that providing care should be the prime decision of the healthcare workers.

Conclusion on Healthcare Workers and Covid-19 Patients

To always believethe fact that healthcare workers will helps and provide care in case of emergency specially during pandemic where the chances of associated risk is more should be minimized.Healthcare workers provide quality care to the patient despite of resources unavailability specifically PPEs. HCW works on achieving primary ethical goals even during pandemic situation. The help from HCW should not be taken granted as this will increase the chances of taking personal decisions and minimize prejudice by setting strict rules for healthcare workers. Government should equally participate to supply all the essential resources for smooth working of the medical institutions. All the factors must be favorable for healthcare care workers to work effectively during COVID-19 pandemic. Healthcare services and HCW should be appreciated despite personal associated harm from COVID-19 patients while saving personal life. The ethical principles must introduce self-care as primary rule for HCW during COVID-19 pandemic.

References for Healthcare Workers and Covid-19 Patients

Bakewell, F., Pauls, M. A., &Migneault, D. (2020).Ethical considerations of the duty to care and physician safety in the COVID-19 pandemic.Canadian Journal of Emergency Medicine, 22(4),1–6.

Barrett, D., Ortmann, L., Dawson, A., Saenz, C., Reis, A., &Bolan, G. (2016). Public health ethics: Cases spanning the globe. Public Health Ethics Analysis, 3(4), 1-10.

Kadish., A. &Loike., J. (2020). A pandemic ethical conundrum: Must health care workers risk their lives to treat Covid-19 patients. Retrieved from https://www .statnews .com/2020/07/24/a-pandemic-ethical -conundrum -must-health-care­workers-risk -their-Jives-to-treat-covid-19-patients/

Kemparaj.,Kadalur,V., &Umashankar. (2018). Understanding the principles of ethics in health care: a systematic analysis of qualitative information. International Journal Of Community Medicine And Public Health, 5(3),82-825.

Kramer, J. B., Brown, D. E., &Kopar, P. K. (2020). Ethics in the time of coronavirus: recommendations in the COVID-19 pandemic. Journal of the American College of Surgeons, 230(6), 1114-1117

Morrison, E. & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.). Retrieved from: http://web.a.ebscohost.com

NMBA.(2020). Regulating Australia's nurses and midwives.Retrieved from https://www.nursingmidwiferyboard.gov.au/.

Orentlicher, D. (20 18). The physician 's duty to treat during pandemics. American Journal ofPublic Health, 108(11), 1459-1461.

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, 2020, 1-4.

Smith,M.J., &Silva,D.S.(2015).Ethics for pandemics beyond influenza: Ebola, drug-resistant tuberculosis, and anticipating future ethical challenges in pandemic preparedness and response. Nature Public Health Emergency Collection.33(2).130-147.

Solnica, A., Barski,., L.&Jotkowitz, A.(2020).The healthcare worker at risk during the COVID-19 pandemic: a Jewish ethical perspective. Journal of Medical Ethics 2020(46), 441-443.

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