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Disciplinary Action, Terminations, Gag Orders: ‘Avalanche Effect’

When the COVID-19 pandemic started, hospitals suddenly had to determine how to ration scarce critical care resources. Hospitals could not change the fact they were caught without enough personal protective equipment (PPE) and could not immediately obtain more of it. However, they could control whether they responded ethically. Some hospitals imposed gag orders on staff, barring them from voicing concerns about PPE publicly. Nurses and physicians have been disciplined or threatened with termination for reporting inadequate PPE on social media.

Making Critical Care Triage Policies Transparent to Patients, Community

Certain hospitals are including information on their critical care triage policies in admission packets to explain how care or supplies will be allocated if rationing becomes necessary. Some clinicians feel ethically obligated to inform everyone up front of the possibility. Others think it is better to do so only if and when it becomes necessary.

Clinical Ethicists ‘Doubling Down’ on Efforts as Hospitals Adjust to New Normal

The COVID-19 pandemic made ethics committees players of central importance. Experts highlight areas around which ethicists can shape the conversation.

Healthcare Workers’ Well-Being Is Ethical Concern During Pandemic

Clinicians always face some risk as they carry out routine duties, including acquiring infection or sustaining injury. However, the pandemic has significantly increased these risks, with healthcare providers around the world acquiring the infection at work.

The COVID-19 Vaccine: Usual Ethical Questions in Unusual Times

Informed consent, protection of human subjects, fairness of testing, and eventual distribution: These all are important ethical questions and considerations surrounding the development of a COVID-19 vaccine.

Shortcuts in Clinical Trials May Cause More Harm Than Good

All clinical trials raise certain ethical issues. But trials conducted during epidemics are especially difficult, both ethically and practically. Poorly designed studies subject patients to the risks of adverse events without learning if the intervention works.

Transparency Is Central Ethical Concern During COVID-19 Pandemic

Developing an ethical framework before disasters helps leaders make better-informed, values-based decisions. This also engenders public trust, easing fear and reducing misinformation.

With Remote Ethics Consults, Nonverbal Communication Is Lost

Normally, ethics consults include plenty of talking, mostly in-person, with patients, families, and clinicians. The need for more remote consults during the COVID-19 pandemic means missing all the communication that happens through facial expressions and body language.

Ethicists Explain Worst-Case Scenario Policies While Exercising Caution

Clinicians nationwide suddenly have multiple urgent concerns on hypothetical COVID-19 scenarios. They are turning to ethicists for answers. At a Missouri-based system, ethicists are working on policies regarding balancing the public good with patients’ right to leave against medical advice, critical care allocation, and modified visitation.

Ethical Policies if Critical Care Resources Become Scarce

If and when there are not enough ventilators for all the COVID-19 patients who need them, hospitals can expect lots of public scrutiny. Clear, consistent, and transparent policies can make the ethical rationale behind decisions obvious to everyone.