Professionalism & Ethics

Ethics of Precaution: Individual and Systemic Risk: Precautionary decisions do not scale. Collective safety may require excessive individual risk avoidance, even if it conflicts with an individual’s own interests and benefits. It may require an individual to worry about risks that are comparatively insignificant.

Who Should Receive Life Support During a Public Health Emergency?: A public health emergency such as an influenza pandemic will lead to shortages of mechanical ventilators, critical care beds, and other potentially life saving treatments. This will raise difficult decisions about who will and will not receive these scarce resources.

The Toughest Triage – Allocating Ventilators in a Pandemic: The COVID-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale.

Fair Allocation of Scarce Medical Resources in the Time of Covid-19: COVID-19 is officially a pandemic. It is a novel infection with serious clinical manifestations, including death, and it has reached at least 124 countries and territories. Although the ultimate course and impact of Covid-19 are uncertain, it is not merely possible but likely that the disease will produce enough severe illness to overwhelm health care infrastructure. Emerging viral pandemics “can place extraordinary and sustained demands on public health and health systems and on providers of essential community services.” Such demands will create the need to ration medical equipment and interventions.

Fight or Flight: The Ethics of Emergency Physician Disaster Repose: Most disaster plans depend on using emergency physicians, nurses, emergency department support staff, and out-of-hospital personnel to maintain the health care system’s front line during crises that involve personal risk to themselves or their families. Planners automatically assume that emergency health care workers will respond. However, we need to ask: Should they, and will they, work rather than flee? The answer involves basic moral and personal issues. This article identifies and examines the factors that influence health care workers’ decisions in these situations.