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Table of Contents
EDITORIAL
Year : 2020  |  Volume : 8  |  Issue : 1  |  Page : 1-2

Bioethics: Challenges in COVID-19 pandemic


Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India

Date of Submission16-Jun-2020
Date of Decision20-Jun-2020
Date of Acceptance21-Jun-2020
Date of Web Publication30-Jun-2020

Correspondence Address:
Dr. A K Seth
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Piparia, Waghodia, Vadodara, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-6486.288693

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How to cite this article:
Seth A K. Bioethics: Challenges in COVID-19 pandemic. J Integr Health Sci 2020;8:1-2

How to cite this URL:
Seth A K. Bioethics: Challenges in COVID-19 pandemic. J Integr Health Sci [serial online] 2020 [cited 2020 Sep 30];8:1-2. Available from: http://www.jihs.in/text.asp?2020/8/1/1/288693



Medical profession is an ethical business. It must abide by all four tenets of bioethics: autonomy, justice, beneficence, and nonmaleficence. All these principles are to be taken care by maintaining the communication about the needs and desires of the patient either in the normal condition or during anomalous conditions. Autonomy deals with the patient's wishes which are supposed to be fulfilled. Justice is another important tenet to be followed to determine limits on health care acceptable to the patients. Moreover, beneficence and nonmaleficence should focus on ensuring a medical professional provides not only all the benefits but also tries to avoid any harm to the patient during the treatment. Thus, bioethics must be an integral part of the life of a medical professional, ensuring the health care of all. With the onset of the year 2020, the COVID-19 pandemic has wreaked havoc globally to human lives and jeopardized our health-care systems with record overload of patients nationwide. Consequently, our not so robust health-care facilities are facing unprecedented circumstances in terms of patient care and treatment, resulting in poor to negligible level of ethics followed, be it patients participating in investigation purpose or coming in for a routine checkup. Many medical professionals are abruptly posted unfamiliar areas bringing unusual challenges due to the lack of experience to deal with such extraordinary scenarios. The acute shortage of skilled manpower forced the authority to call retired doctors, final-year medical students, and interns to participate in a frontline role to control the pandemic situation. As COVID-19 engulfs the globe with a blitzkrieg, it is obvious that the principles of bioethics may not be followed due to the dearth of available medical resources. Despite these challenging times of pandemic, medical professionals are working round the clock at their best to provide support, information, and advice to cater people in need of medical attention, ensuring a certain level of bioethics intact in these baffling times. One of the key attributes that makes severe acute respiratory syndrome coronavirus 2 so deadly is the fact that it is not so “deadly” in terms of the mortality rate, but it is highly contagious as it gets transmitted easily through respiratory droplets while coughing or sneezing.[1],[2]

An acute demand of emergency medical services (EMS) personnel on the front lines of COVID-19 pandemic is generated with the ethical challenges. EMS personnel face deficiency of personal protective equipment (PPE) and proper advisory from the health ministry to deal with such pandemic. Subsequently, a huge ethical challenge had come in front of individual clinicians in not only protecting themselves but also their families, patients, and their communities. A situation of ethical quandary posed for the medical fraternity with a gigantic gap between the demand and supply of various protective medical kits such as PPE, masks, gloves, and gowns. Should they protect themselves or their patients by putting their own life in jeopardy? On the one hand, their Hippocratic Oath forces them to give the full intention to the patients, but on the other hand, they have not been provided with the proper equipments to deal with such extraordinary situations. Health-care professionals had to face an unusual dilemma of whether to keep themselves safe or to stand by their oath and selflessly serve their patients no matter the risk involved.

Beauchamp and Childress [3] articulate four core principles of biomedical ethics governing to guide for making decision in health care, i.e., respect for autonomy, beneficence, nonmaleficence, and justice. Ethics in EMS has also focused on virtue and teamwork.[4] What may be the ethical concern? Primarily, clinicians are facing very sensitive ethical concerns such as (a) caring patients during the pandemic in the absence of proper PPE, (b) in case, if a clinician is in high-risk group due to age or medical history, should he be continue to care for patients in the absence of proper PPE, (c) if the clinician lives with family members who are in a high-risk group due to age or medical history, should he be continue to care for patients in the absence of having proper PPE, and (d) if the clinician believes that he might be spreading the virus to patients, patient family members, colleagues, and/or community members, should he be continue to care patients in the absence of having proper PPE?

All these ethical issues are resolved if the clinicians are provided with the proper PPE and other necessary protective accessories. EMS clinicians must assume that wherever they go and whatever they touch everything is contaminated. Everyone they meet is contagious and they themselves are contagious. Thus, there should not be any way out except to provide the proper PPE to clinicians and the health workers to provide them the opportunity to prove their obligation to treat all patients because they chose their profession bound with Hippocratic Oath. However, it is the responsibility of the administration to make them available all the necessary protective equipments without which health-care professionals are handicapped even if they are bound with the Oath.

Being a health-care professional, no one would prefer to flout from following the tenets of bioethics. COVID-19 pandemic has made our government realize the need to have a robust health-care system with ample medical resources and equipments available at their disposal to serve the maximum number of patients during such times and help mitigate the risk to save human lives. In my opinion, the COVID-19 pandemic has brought a great opportunity not only for the medical fraternity but also for the government to realize the age old saying, “Health is Wealth” in its true essence. Keeping health care in the forefront of our economy is imperative more than ever if we want to grow into a developed and flourishing economy in future.

Moreover, I believe the government should frame a new policy on a priority basis with regard to the safety of health-care workers and patients in these challenging times of pandemic.

I feel proud of our health workers to be on the forefront throughout and expect from the administration to avail them with required allowances and protection needed to keep working at their best potential.

I wholeheartedly commend the bravery, commitment, and gallant shown by our health-care warriors in such a global medical crisis and still putting up with their best efforts at maintaining the bioethics while treating COVID-19 patients. I strongly appeal to each one of you to recognize and appreciate our health-care warriors for their passion of selfless service to the humankind in this pandemic.



 
  References Top

1.
Liu J, Liao X, Qian S, Yuan J, Wang F, Liu Y, et al. Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China, 2020. Emerg Infect Dis 2020;26:1320-3.  Back to cited text no. 1
    
2.
Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet 2020;395:514-23.  Back to cited text no. 2
    
3.
Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 6th ed.. New York: Oxford University Press; 2009.  Back to cited text no. 3
    
4.
Larkin GL, Fowler RL. Essential ethics for EMS: Cardinal virtues and core principles. Emerg Med Clin North Am 2002;20:887-911.  Back to cited text no. 4
    




 

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