Skip to main content

Ethical Issues Related to Coronavirus Disease

  • Chapter
  • First Online:
Clinical Synopsis of COVID-19
  • 855 Accesses

Abstract

The COVID pandemic has put immense pressure on the healthcare systems all over the globe. Because of the high virulence of the virus, it has become extremely difficult to control its spread. With more and more people getting infected every day, there is a scarcity of resources in terms of man power, critical care beds, and diagnostic and therapeutic interventions. This chapter broadly discusses the ethical issues faced by healthcare workers while working in these extraordinary circumstances. Hospitals need to find transparent and equitable solutions for allocation of ICU beds and ventilators, supply of PPE for their workers along with psychological support, high-quality palliative care for the dying, scientific and ethical research models, and use of alternative medicines. Legally no person can be denied his fundamental right to health care. Till the time we do not have an effective drug or vaccine to control its spread, the healthcare workers have to work within the acceptable norms of their region or state to look after the sick.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Simonds AK, Sokol DK. Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters. Eur Respir J. 2009;34(2):303–9.

    Article  CAS  PubMed  Google Scholar 

  2. Berlinger N, Wynia M, Powell T, Milliken A, Fabi R, Cohn F, Guidry Grimes LK, et al. Ethical Framework for Health Care Institutions responding to novel coronavirus SARS-CoV-2 (COVID-19),guidelines for institutional ethics services responding to COVID-19 managing uncertainty, safeguarding communities, guiding Practice. The Hastings Center; 16 March 2020.

    Google Scholar 

  3. Gopichandran V. Clinical ethics during the Covid-19 pandemic: missing the trees for the forest. Indian J Med Ethics. Online first published April 30, 2020.

    Google Scholar 

  4. Davies C, Shaul R. Physicians’ legal duty of care and legal right to refuse to work during a pandemic. CMAJ. 2010;182(2):167–70.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tait S, Jonathan R, Mickey T. Addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA. 2020;323(21):2133–4.

    Article  Google Scholar 

  6. Menon V, Padhy SK. Ethical dilemmas faced by health care workers during COVID-19 pandemic: issues, implications and suggestions. Asian J Psychiatr. 2020;51:1–2.

    Article  Google Scholar 

  7. Draper H, Sorell T, Ives J, Damery S, Greenfield S, Parry J, et al. Non-professional healthcare workers and ethical obligations to work during pandemic influenza. Public Health Ethics. 2010;3(1):23–34.

    Article  Google Scholar 

  8. Verano M, Bartolini G, Giannini A, Gristina G, Livigni S, Mistraletti G, et al. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: the Italian perspective during the COVID-19 epidemic. Crit Care. 2020;165(24):1–3.

    Google Scholar 

  9. De Pergola PA. Ethical guidelines for the treatment of patients with suspected or confirmed novel coronavirus disease (COVID-19). Online J Health Ethics. 2020;16(1):1–59.

    Google Scholar 

  10. Hick JL, Hanfling D, Wynia MK, Pavia AT. Duty to plan: health care, crisis standards of care, and novel coronavirus SARS-CoV-2. NAM perspectives discussion paper. National Academy of Medicine; 2020. p. 1–13.

    Google Scholar 

  11. White DB, Katz MH, John LJM, Lo B. Who should receive life support during a public health emergency? Using ethical principles to improve allocation decisions. Ann Intern Med. 2009;150(2):132–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Robert R, Kentish-Barnes N, Boyer A, Laurent A, Azoulay E, Reignier J. Ethical dilemmas due to the Covid-19 pandemic. Ann Intensive Care. 2020;10:84.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Singh JA, Moodley K. Critical care triaging in the shadow of COVID-19: ethics considerations. S Afr Med J. 2020;110(5):355–9.

    CAS  PubMed  Google Scholar 

  14. Maves R, Downar J, Dichter J, Hick J, Devereaux A, Geiling J, et al. Triage of scarce critical care resources in COVID-19 an implementation guide for regional allocation an expert panel report of the task force for mass critical care and the American College of Chest Physicians. Chest. 2020;158(1):212–25.

    Article  CAS  PubMed  Google Scholar 

  15. Emanuel E, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med. 2020;382(21):2049–55.

    Article  PubMed  Google Scholar 

  16. White D, Lo B. A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. JAMA. 2020. Viewpoint E1-E2.

    Google Scholar 

  17. Hurford J. The BMA COVID-19 ethical guidance: a legal analysis. New Bioeth. 2020;26(2):176–89.

    Article  Google Scholar 

  18. Kramer J, Brown D, Kopar P. Ethics in the time of coronavirus: recommendations in the COVID-19 pandemic. J Am Coll Surg. 2020;230(6):1114–8.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Livingston E, Desai A, Berkwits M. Sourcing personal protective equipment during the COVID-19 pandemic. JAMA. 2020;323(19):1912–4.

    Article  CAS  PubMed  Google Scholar 

  20. Centres for Disease Control and Prevention. Strategies for optimizing the supply of facemasks. 2020. Updated June 28, 2020.

    Google Scholar 

  21. White Paper on standards and norms for hospice and palliative care in Europe: part 1 Recommendations from the European Association for Palliative Care. Eur J Palliat Care. 2009;16(6):278–9.

    Google Scholar 

  22. Fausto J, Hirano L, Lam D, Mehta A, Mills B, Owens D, et al. Creating a palliative care inpatient response plan for COVID19—The UW medicine experience 2020. J Pain Symptom Manage. 2020;60(1):e21–6.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gamondi C, Larkin P, Payne S. Core competencies in palliative care: an EAPC white paper on palliative care education – part 1. Eur J Palliat Care. 2013;20(2):86–91.

    Google Scholar 

  24. Downar J, Seccareccia D. Palliating a pandemic: “all patients must be cared for”. J Pain Symptom Manage. 2010;39(2):291–5.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Arya A, Buchman S, Bruno Gagnon B, Downar J. Pandemic palliative care: beyond ventilators and saving lives. CMAJ. 2020;early-released 1–5.

    Google Scholar 

  26. Etkind S, Bone A, Lovell N, Cripps R, Harding R, Higginson I, et al. The role and response of palliative care and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic. J Pain Symptom Manage. 2020;60(1):e31–40.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Pattison N. End-of-life decisions and care in the midst of a global coronavirus (COVID-19) pandemic. Intensive Crit Care Nurs. 2020;58:102862.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Radbruch L, Knaul F, Lima L, Joncheere C, Bhadelia A. The key role of palliative care in response to the COVID-19 tsunami of suffering. Lancet. 2020;395:1467–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Fadul N, Elsayem AF, Bruera E. Integration of palliative care into COVID-19 pandemic planning. BMJ Support Palliat Care. 2020;bmjspcare-2020-002364.

    Google Scholar 

  30. Payne S, Tanner M, Hughes S. Digitisation and the patient–professional relationship in palliative care. Palliat Med. 2020;34(4):441–3.

    Article  PubMed  Google Scholar 

  31. Hancock S, Preston N, Jones H, Gadoud A. Telehealth in palliative care is being described but not evaluated: a systematic review. BMC Palliat Care. 2019;18:114):1–15.

    Article  Google Scholar 

  32. Lapid M, Koopmans R, Sampson E, Block LV, Peisah C. Providing quality end-of-life care to older people in the era of COVID-19: perspectives from five countries. Int Psychogeriatr. 2020:1–8.

    Google Scholar 

  33. Joebges S, Biller-Andorno N. Ethics guidelines on COVID-19 triage—an emerging international consensus. Crit Care. 2020;24(201):1–5.

    Google Scholar 

  34. Nolan JP, Monsieurs KG, Bossaert L, Bottiger BW, Greif R, Lott C, et al. European Resuscitation Council COVID-19 guidelines executive summary. Resuscitation. 2020;153:45–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. International Liaison Committee on Resuscitation. COVID-19 infection risk to rescuers from patients in cardiac arrest; 30 March 2020.

    Google Scholar 

  36. Craig S, Cubitt M, Jaison A, Troupakis S, Hood N, Fong C, et al. Management of adult cardiac arrest in the COVID-19 era. Interim guidelines from the Australasian College for Emergency Medicine. Med J Aust. 2020;213(3):126–33. (published online: 24 April 2020).

    Article  PubMed  PubMed Central  Google Scholar 

  37. Singh B, Garg R, Chakra Rao S, Ahmed SM, Divatia JV, Ramakrishnan TV, et al. Indian Resuscitation Council (IRC) suggested guidelines for Comprehensive Cardiopulmonary Life Support (CCLS) for suspected or confirmed coronavirus disease (COVID-19) patient. Indian J Anaesth. 2020;64:S91–6.

    Article  PubMed  PubMed Central  Google Scholar 

  38. DeFilippis E, Ranard L, Berg D. Cardiopulmonary resuscitation during the COVID -19 pandemic CPR a view from trainees on the front line. Circulation. 2020;141:1833–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Ott M, Milazzo A, Liebau S, Jaki C, Schilling T, Krohn A, et al. Exploration of strategies to reduce aerosol-spread during chest compressions: a simulation and cadaver model. Resuscitation. 2020;152:192–8.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kramer D, Lo B, Dickert N. CPR in the Covid-19 Era - an ethical framework. N Engl J Med. 2020;383:e6.

    Article  CAS  PubMed  Google Scholar 

  41. Global coalition to accelerate COVID-19 clinical research in resource-limited settings. Lancet. 2020;395:1322–5.

    Google Scholar 

  42. Dean N, Gsell P, Brookmeyer R, Crawford F, Donnelly C, Ellenberg S, et al. Creating a framework for conducting randomized clinical trials during disease outbreaks. N Engl J Med. 2020;382(14):1366–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Lurie N, Saville M, Hatchett R, Halton J. Developing Covid-19 vaccines at pandemic speed. N Engl J Med. 2020;382(21):1969–73.

    Article  CAS  PubMed  Google Scholar 

  44. Statement on Covid-19: ethical considerations from a global perspective Statement of the UNESCO International Bioethics Committee (IBC) and the UNESCO World Commission on the Ethics of Scientific Knowledge and Technology (COMEST) at, www.https://en.unesco.org/themes/ethics-science-and-technology/comest (Accessed on 20.09.2020).

    Google Scholar 

  45. Tansey S, Cottam B, Dollow S, Lockett A, Miils I, Vranic I. The ethics of conducting clinical trials in the search for treatments and vaccines against COVID-19. Faculty of Pharmaceutical Medicine blog; 21 April 2020.

    Google Scholar 

  46. Kalil A. Treating COVID-19—off-label drug use, compassionate use, and randomized clinical trials during pandemics. JAMA. 2020;323(19):1897–8.

    Article  CAS  PubMed  Google Scholar 

  47. Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A, et al. Compassionate use of remdesivir for patients with severe Covid-19. N Engl J Med. 2020;382:2327–36.

    Article  CAS  PubMed  Google Scholar 

  48. Hollander J, Carr B. Virtually Perfect? Telemedicine for Covid-19. N Engl J Med. 2020;382(18):1679–81.

    Article  CAS  PubMed  Google Scholar 

  49. Vidal-Alaball J, Acosta-Roja R, Hernandez N, Luque U, Morrison D, Perez S, et al. Telemedicine in the face of the COVID-19 pandemic. Aten Primaria. 2020;52(6):418–22.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Hau YS, Kim JK, Hur J, Chang MC. How about actively using telemedicine during the COVID-19 pandemic? J Med Syst. 2020;44:107–8.

    Article  Google Scholar 

  51. Ienca M, Vayena E. On the responsible use of digital data to tackle the COVID-19 pandemic. Nat Med. 2020;26:458–64.

    Article  Google Scholar 

  52. Calton B, Abedini N, Fratkin M. Telemedicine in the time of coronavirus. J Pain Symptom Manage. 2020;60(1):e12–4.

    Article  PubMed  PubMed Central  Google Scholar 

  53. World Health Organization. Notes for the record: consultation on monitored emergency use of unregistered and investigational interventions for Ebola Virus Disease (EVD). Geneva: WHO.

    Google Scholar 

  54. Ministry of Health and Family Welfare, National Health Policy 2017. New Delhi: Ministry of Health and Family Welfare, National Health Policy; 27 August 2018.

    Google Scholar 

  55. Chaturvedi S, Kumar N, Tillu G, Deshpande S, Patwardhan B. AYUSH, modern medicine and the Covid-19 pandemic. Indian J Med Ethics. Published online on May 13, 2020.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wanchoo, J. (2020). Ethical Issues Related to Coronavirus Disease. In: Prabhakar, H., Kapoor, I., Mahajan, C. (eds) Clinical Synopsis of COVID-19. Springer, Singapore. https://doi.org/10.1007/978-981-15-8681-1_15

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-8681-1_15

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-8680-4

  • Online ISBN: 978-981-15-8681-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics