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Healthcare Workers Have a Moral Obligation to Care for Covid-19 Patients and Cannot Object to Caring for These Patients

Ethics in healthcare are imperative as they not only help in the determination of moral conduct but also establish a code for what is right and not in the care practice (Savage, 2017). This helps in the resolution of dilemmas and prevents conflicts by merging the opinions under what is ethically right or wrong in the clinical practice (Johnstone, 2019). The ethics in nursing are also important as they help in the formation of a stencil for the actions to be taken by the healthcare professionals (Kerridge et al., 2013). In times of a pandemic like COVID-19, the health care workers are bound under moral obligations to work tirelessly to ensure the well being of the community at large (Menon & Padhy, 2020). This essay will present an argument on the obligated participation of the nurses for caring for the patients suffering from COVID-19 in conjunction with four core ethical principles of nursing.

The ethical principles in healthcare aim to ensure that all patients achieve high-quality care with complete acknowledgement of their care needs and intended improvement and recovery (Carter et al., 2016)). However, application of these principles in care practices can sometimes result in conflicts and dilemmas in nursing practice. The primary ethical principles of nursing that are universally applicable include autonomy, beneficence, non-maleficence, and justice (Doody & Noonan, 2016). Autonomy is defined as the authority and power of the patient to make an informed decision regarding the care and clinical interventions (Ozoliņš, 2015). Beneficence as an ethical principle is applied in healthcare to ensure that all the decisions that are taken for the care of the patient are beneficial for the health of the patient and are intended to improve the health of the patient (McDermott-Levy et al., 2018). The ethical principle of non-maleficence obliges healthcare professionals to make decisions to do no intended harm to the patient and function to enhance the overall care provided to the patient.

The fourth ethical principle of justice is applied in healthcare practice to ascertain that all the patients are treated fairly with justice and no prejudice to ensure highest quality care (Savage, 2017). In special consideration with the ongoing pandemic, application of these principles can become even more difficult in the nursing practices. It can be argued that the nurses and health care professionals are obliged to work in the COVID care facilities to facilitate recovery and manage the disease in the community. The healthcare workers in these situations thus have a moral obligation to care for the COVID patients and cannot object to caring for these patients. This poses a direct risk of disease transmission and outs the health workers at an increased risk of getting the disease. In the particular case of COVID-19 (Sun et al., 2020). The need for distance and limited interaction is the top priority. The healthcare professionals are constantly in close contact with the patients and mitigating their care and response. It is this cases that adhering to the ethical principles of patient autonomy and beneficence can be conflicting. Isolation and quarantine of patients that have tested positive for COVID can be difficult for the patient and they may argue regarding the same. It is when healthcare workers are conflicted and are subjected to choose between patient autonomy and beneficence (Sun et al., 2020).

The ethical principle of nursing, justice demands healthcare professionals to treat every patient with prejudice-free and just treatment. However, treatment of patients that suffer from COVID-19 requires seclusion and this may affect how the treatment is perceived by the patient and may appear to be partial and biased (Rosenbaum, 2020). This, therefore, impacts the overall behaviour towards the nurses and how the relationship between the patients and the healthcare professionals. There have also been multiple incidences of pseudoscientific beliefs that have impacted how patients act and behave in these facilities and among the COVID care workers. The primary precaution for COVID-19 has been to wear masks and maintain a social distance. However, unfortunately, reportedly globally there have been individuals that have not compiled to these norms (Rosenbaum, 2020). Therefore, it becomes critical for the healthcare workers to ensure using personal protective kits and even deal with these patients that do not wish to comply. It becomes the moral imperative for the nurses and healthcare practitioners to ensure the well being of the patients in such cases as well and treat them to ensure the beneficence and recovery.

The non-compliance of the patients to the primary safety procedures can, therefore, result in an ethical dilemma for the healthcare professionals where they may be forced to take measures to control the viral spread for the beneficence of the community (Sun et al., 2020). Mutual respect is a critical virtue of ethical nursing practice and needs to be dealt with utmost significance as it not only helps in rapport building but also ensures the well being of the patient by the provision of the necessary information for the patient to make an informed choice which is compromised in such situations. Therefore, it is only human for health care professionals to be stricken by a dilemma in practice (Menon & Padhy, 2020). The ethical dilemmas in healthcare practice are also associated with the fact that health care professionals are obligated to work for patients without objecting. This presents an unprecedented challenge. The high virulence of the SARS-CoV-2 makes it difficult for healthcare professionals to cope with the patients that do not comply with the set standards and care procedures. This may affect the rationality and decision making for the healthcare professionals as they may ponder over how to protect themselves and their family in these times as they approach a patient.

These concerns are further heightened with the limited availability of the personal protective equipment and the inequitable availability of the resources (Farrell et al., 2020). Other than decision making associated with moral handling with the patients, dilemmas may also arise in dealing with the patient needs about ventilator provision, identification of symptoms, need of quarantine, and making a crucial observation. But the critical question in the argument remains if it is morally correct to push healthcare workers in such high-risk situations without direct consent and expect a bias-free duty in such critical times (Menon & Padhy, 2020).

There has been a global surge in the need of healthcare professionals directing the immense need of healthcare professionals in the field with the rise in the number of confirmed cases across the world. The healthcare professionals have not only been overworked but also mentally and physically exhausted. In such situations, therefore it becomes even more crucial to develop guidelines and laws that not only ensure the safety of the healthcare professionals but also provides the direction in the course of taking the required actions. The Nursing and Midwifery Board of Australia has established a code of conduct that obliges the healthcare professionals to ensure the best quality care for the patients and ensure the ethical and moral duties as well as the professional duties as a healthcare professional (Nursing and Midwifery Board of Australia, 2018). According to this code and the National Law obligations the nurses and healthcare professionals are obliged to work to ensure patient safety, well being, and beneficence. Further, COVID-19 guidelines have also been released by the government of Australia through the Nursing and Midwifery Board of Australia.

The COVID-19 guidelines by the Nursing and Midwifery Board of Australia ask the healthcare professionals to ensure the use of personal protective equipment and not place harm at their health (Nursing and Midwifery Board of Australia, 2020). The suspicion of infection in a healthcare professional must be dealt with the current public health advice that includes self-isolation and medical care. The COVID-19 guidelines by the Nursing and Midwifery Board of Australia also assert on care through the use of required precautions for the treatment of the patients that have been diagnosed for COVID-19 (Nursing and Midwifery Board of Australia, 2020). Yet the risks associated with this care and the constant need of maintaining precautions to maintain safety cannot be ignored and therefore demand a critical discussion. There is also a need to identify the cases and the methods to deal with non-compliant individuals in the practice and how to contain infection through them and manage their treatment and cure most ethically to protect their medical rights and also ensure the safety of the healthcare professionals (Farrell et al., 2020).

This essay provides a concise argument over the notion of the obligation of care provision in times of COVID-19 by the health care professionals. This essay explores the four primary ethical principles of justice, autonomy, beneficence, and non-maleficence application in the pandemic. This essay also discusses the existing national policies to govern the code of conduct and the need of suitable guidelines to ensure that the safety of the healthcare professionals is not compromised while they fulfil their moral imperatives and ensure the safety of individuals in the community.

References for Nursing Obligations in Times of Covid-19

Carter, D., Gordon, J., & Watt, A. M. (2016). Competing principles for allocating health care resources. Journal of Medicine and Philosophy, 41(5), 558-583. https://academic.oup.com/jmp/article-abstract/41/5/558/2222397

Doody, O., & Noonan, M. (2016). Nursing research ethics, guidance and application in practice. British Journal of Nursing, 25(14), 803-807. https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2016.25.14.803

Farrell, T. W., Francis, L., Brown, T., Ferrante, L. E., Widera, E., Rhodes, R., ... & Liu, S. W. (2020). Rationing limited health care resources in the COVID‐19 era and beyond: Ethical considerations regarding older adults. Journal of the American Geriatrics Society. 382(20), 1873-1875. https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16539

Johnstone, M. J. (2019). Bioethics: A nursing perspective. United Kingdom: Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=Z_uRDwAAQBAJ&oi=fnd&pg=PP1&dq=autonomy+justice+beneficence+and+nonmaleficence+nursing&ots=QhSR7H2_J_&sig=iYwA3ZOhvUrv1-TCxIlvOXJfMBg

Kerridge, I., Lowe, M., & Stewart, C. (2013). Ethics and law for the health professions. Sydney: Federation Press. https://research.usc.edu.au/discovery/fulldisplay?vid=61USC_INST%3AResearchRepository&docid=alma9911272902621&lang=en&context=SP

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook, 66(5), 473-481. https://www.sciencedirect.com/science/article/pii/S0029655418301738

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

Nursing and Midwifery Board of Australia (2018). Code of conduct. Retrieved from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiJpYfUvafrAhWBcn0KHWM2C_EQFjACegQIBRAB&url=https%3A%2F%2Fwww.nursingmidwiferyboard.gov.au%2Fcodes-guidelines-statements%2Fprofessional-standards.aspx&usg=AOvVaw1_uNJ6G6fovBNmbGN-34La

Nursing and Midwifery Board of Australia (2020). COVID-19 guidance for nurses and midwives. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/COVID19-guidance.aspx

Ozoliņš, J. T. (2015). Foundations of Healthcare Ethics. Cambridge University Press. https://books.google.com/books?hl=en&lr=&id=rQMHBwAAQBAJ&oi=fnd&pg=PR7&dq=Ozolins,+J.,+%26+Grainger,+J.+(2015).+Foundations+of+healthcare+ethics.+Port+Melbourne,+Vic.+:+Cambridge+University+Press.&ots=Ww6rhKszNY&sig=Id3rE3V4YQIpVVQ1PBVCpipwSN0

Rosenbaum, L. (2020). Facing Covid-19 in Italy: Ethics, logistics, and therapeutics on the epidemic’s front line. New England Journal of Medicine, 382(20), 1873-1875. https://www.nejm.org/doi/full/10.1056/NEJMp2005492

Savage, T. A. (2017). Ethical issues in school nursing. OJIN: The Online Journal of Issues in Nursing, 22(3), 79. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-22-2017/No3-Sep-2017/Ethical-Issues-in-School-Nursing.html

Sun, N., Wei, L., Shi, S., Jiao, D., Song, R., Ma, L., ... & Liu, S. (2020). A qualitative study on the psychological experience of caregivers of COVID-19 patients. American Journal of Infection Control, 48(6), 592-598. https://www.sciencedirect.com/science/article/pii/S0196655320302017

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