Clinical ethics during the Covid-19 pandemic: Missing the trees for the forest

Indian J Med Ethics. 2020 Apr 30;-(-):1-5. doi: 10.20529/IJME.2020.053. Online ahead of print.

Abstract

The SARS-CoV2 pandemic has exposed the acute vulnerability of the health systems of countries worldwide. While countries are scrambling to contain the spread of the infection, the focus is largely on infection prevention strategies such as isolation, quarantine, physical distancing, hand hygiene, cough etiquette and country-wide lock-down. Important ethical concerns arise in the context of the public health interventions. However, while focusing on the forest, the population, attention must also be paid to the trees, the individuals who suffer the illness. This article focuses on the ethical conflicts between the largely public health- driven focus of the Covid19 prevention and containment measures versus patient-centred care for those who suffer the illness and the consequent moral distress of healthcare providers. The key argument is for countries to mainstream clinical ethics considerations for care of patients with Covid-19 as well as "non-Covid-19" illnesses. Keywords: SARS-CoV2, Covid 19, clinical ethics, duty to care, allocation of scarce resources, moral distress.