• Subject Name : Nursing

Relational Ethical Approaches to The Covid-19 Pandemic

All the people around the world are in the middle of COVID-19 pandemic and apparently, there is no vaccine in the market for this deadly disease which is effective and can treat the patients (BMA, United Kingdom, 2020). Based on the current data, it is evident the impact of the disease is growing day by day. More and more people are falling ill because of coronavirus disease. According to the World Health Organization report, 24,587,513 cases have been confirmed. Out of that, 833,556 have lost their lives (World Health Organization, 2020). Because of the pandemic, healthcare professionals like doctors and nurses have a lot of pressure. Many of them are working in unfamiliar areas and find it very difficult to work beyond their limitations of expertise. Therefore, in these challenging times, healthcare professionals are concerned with providing safe and quality care which is ethically right. They also worry about their own safety and health and as well as for their friends and family (BMA, United Kingdom, 2020). These things arise some ethical challenges for them as they have a moral obligation to care for COVID-19 patients and cannot object to caring for these patients.

Healthcare professionals have obligations to take care of the diseased individuals as this was embedded in the beneficence principle. These obligations have aroused from an understanding of the society of what is wrong and what is right behaviour and what appeals more to the values which are universally held. There is a very strong debate going on for recognising the moral responsibility to give quality care in the time of pandemic especially to those people who are admitted to the intensive care unit (ICU) and others. However, these moral responsibilities towards work are not indefinite. Aspects such as danger to the worker himself or his family, competing care duties towards patients and family care should be taken into account. Obligation towards profession is based on the fact that how the people who are part of the profession should behave and this should be stated out in the guidelines, policies and code of ethics. Nurses, Doctors and other healthcare workers have a moral duty to take quality care of the patient suffering from COVID-19 with all the dignity and respect and that he cannot refuse to do his job out of fear of getting the disease. This role of theirs is mentioned in the ethical code of their profession. Even though all the attention is towards healthcare professionals but the duty of care also expands towards all the other health workers because without their help every function will come to stop. Therefore, healthcare workers regardless of their role have the moral duty towards serving patients suffering from COVID-19 despite having the risk that they might themselves caught the disease while working with patients. These obligations become mandatory when healthcare professionals or workers take an oath to serve the patient before entering into the profession of medicine. And it is also important for the hospitals to provide safe and protective care to their workers and staff members (Jeffrey, 2020).

The other ethical code which healthcare workers need to follow is the principle of non-maleficence. This principle promotes the well-being of the patients and that there is no intension to injure or harm the patient. A healthcare professional should fulfil their duty in a way by which they don’t harm the patient. In the case of coronavirus, workers should help in a way that does not cause any problem or harm to the COVID-19 patient (Schröder-Bäck et al., 2014). Another ethical code which should be kept in mind is autonomy. In this, healthcare professionals should have the intension and authority to make decisions for the welfare of the patient. This principle also mentioned that every individual who has disease persist high value and they cannot be used as goods for meeting the needs of others. Therefore, the COVID-19 patients should be treated in a manner which uplifts their values and doctor should make informed decisions by partnering with the patient himself so as to work towards the welfare of the diseased individual (Schröder-Bäck et al., 2014). Justice is one of the ethical codes which need to be followed by a healthcare worker. It demands chances that there will a fair amount of distribution of health. This also means the worker or professional is honest and fair with the patient and in the care that he is providing to the patient. Hence, in the case of coronavirus patients, healthcare workers should do their duties with all honesty and fairness (Schröder-Bäck et al., 2014).

Healthcare workers, who are having a responsibility towards patients, have one more duty that is to take care of their families and to protect the members from any harm or danger. However, these obligations are interconnected. If the healthcare worker does not perform his/her duty then there will be more chance of spreading the disease and members of his family will have more probability of acquiring and transferring the disease to rest of the family members. There are ways by which a worker can reduce the risks but not doing his tasks will burden his/her other colleagues. Other than healthcare professionals, the medical institutions, organization and hospital also have the responsibility to help the workers managing their obligations. Because these people endangering their lives and treating affected individuals, it is the role of healthcare institutions to make sure the well being of the workers. They should help the workers by managing their obligations towards family, providing them with proper personal protective (PPE) and also other things which help to reduce the chance of acquiring coronavirus within the workplace. These institutions should guarantee to provide the workers with proper space. They should make sure that significant equipment is present for the use of workers. They should also give and maintain conditions which are safe to operate so that the best care can be given to the patient. They should also help healthcare workers to deal with work and pandemic related stress and anxiety. They should also continuously revise and review their policies and guidelines to make improvements in patient care even in the middle of a pandemic. Healthcare institutions should also provide workers with relevant information and knowledge in a timely manner. The information should consist of basic details about coronavirus and its management. Besides all of this, healthcare workers should be provided with PPE, supplies of the laboratory testing and medications so that they can carry out their moral obligations (Laventhal et al., 2020).

In the conclusion, it can be said that healthcare workers have their moral obligations to serve and treat the patients who are suffering from coronavirus disease. They have to work even if they fear they might catch the infection themselves as they have taken an oath to always deliver care to the people who are in need of help. While they are working, they should make sure to follow all the ethical codes and rules so that they can give quality practice in treating the patients. The four main ethics healthcare workers need to follow are beneficence, non-maleficence, autonomy and justice. If they don’t follow their responsibility and only think about their obligations towards their family then the extra burden will be created on his/her colleagues. Healthcare institutions and facilities should help the workers to play their role and complete their moral obligations. They can do this by updating policies and providing the workers with necessary items such as PPE for taking care of the COVID-19 affected patient.

References for Healthcare Workers and Their Moral Obligations

BMA, United Kingdom. (2020). COVID-19-ethical issues. A guidance note. Available at https://www.bma.org.uk/media/2226/bma-covid-19-ethics-guidance.pdf

Jeffrey D. I. (2020). Relational ethical approaches to the COVID-19 pandemic. Journal of Medical Ethics46(8), 495–498. https://doi.org/10.1136/medethics-2020-106264

Laventhal, N. T., Basak, R. B., Dell, M. L., Elster, N., Geis, G., Macauley, R. C., ... & Diekema, D. S. (2020). Professional Obligations of Clinicians and Institutions in Pediatric Care Settings During a Public Health Crisis: A Review. The Journal of Pediatrics, 224, 10-15.

Schröder-Bäck, P., Duncan, P., Sherlaw, W., Brall, C., & Czabanowska, K. (2014). Teaching seven principles for public health ethics: Towards a curriculum for a short course on ethics in public health programmes. BMC Medical Ethics15, 73. https://doi.org/10.1186/1472-6939-15-73

World Health Organization, (2020). WHO coronavirus disease (COVID-19) dashboard. Available at https://covid19.who.int/

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