Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 6;/j/jpme.ahead-of-print/jpm-2020-0174/jpm-2020-0174.xml.
doi: 10.1515/jpm-2020-0174. Online ahead of print.

Expanding the Concept of the Professional Integrity of Obstetrics During a Public Health Emergency

Affiliations

Expanding the Concept of the Professional Integrity of Obstetrics During a Public Health Emergency

Frank A Chervenak et al. J Perinat Med. .

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has placed great demands on many hospitals to maximize their capacity to care for affected patients. The requirement to reassign space has created challenges for obstetric services. We describe the nature of that challenge for an obstetric service in New York City. This experience raised an ethical challenge: whether it would be consistent with professional integrity to respond to a public health emergency with a plan for obstetric services that would create an increased risk of rare maternal mortality. We answered this question using the conceptual tools of professional ethics in obstetrics, especially the professional virtue of integrity. A public health emergency requires frameshifting from an individual-patient perspective to a population-based perspective. We show that an individual-patient-based, beneficence-based deliberative clinical judgment is not an adequate basis for organizational policy in response to a public health emergency. Instead, physicians, especially those in leadership positions, must frameshift to population-based clinical ethical judgment that focuses on reduction of mortality as much as possible in the entire population of patients served by a healthcare organization.

Keywords: COVID-19 pandemic; frameshifting; professional ethics in obstetrics; professional virtue of integrity; public health emergency.

Similar articles

See all similar articles

LinkOut - more resources

Feedback