The COVID-19 Conundrum: An ethical dilemma surrounding the duties of healthcare workers

Written by Simonne Rauch

The ongoing COVID-19 pandemic is among the top public health threats and has raised a fundamental question surrounding medical ethics. Do healthcare workers have a duty to care for infected patients, even if it means putting themselves and their families at high risk?  This review article explores two sides to the same story, aiming to bridge the gap. 
Refusal to Work is Justified: 
To date, over 90,000 healthcare workers in Canada have been infected with COVID-19, accounting for 11%-16% of COVID-19 infections during the first wave. Why should healthcare workers feel obligated to risk their health for the benefit of someone else? According to the American Medical Association, if the risks of providing care to individual patients are too dangerous, physicians should refrain from treating them as it may hinder their ability to provide future care. In any other designation, companies strive to create a safe and comfortable workspace where participants feel their rights are respected. Why should this be any different for healthcare workers? 
 Secondly, we should consider the role of moral obligations.  Healthcare workers have the moral obligation to avoid harm against others, but what about harming themselves?  Healthcare practitioner self-care is primarily overlooked when in fact, it should be prioritized. These occupations have high burnout and turnover rates, two factors that can be alleviated with choice and freedom within a job.
 Lastly, it is essential to consider that besides being healthcare professionals, these individuals are parents, siblings, and children like our loved ones. Is it fair that these individuals put their families at higher risk for infection because of their occupation? Take, for example, a healthcare worker with an immunocompromised family member.  If this worker contracts COVID-19, they not only further transmission rate but increase the morbidity for their immunocompromised loved one. Should healthcare professionals have to isolate themselves to keep their primary group safe?  Is refusal to work justified if the well-being of front-line workers is endangered?

Healthcare workers save lives - Unconditionally:  
 Opponents argue that refusal to work should lead to job dismissal.  As with any other profession, it is warranted to let an employee go if they do not meet job expectations. Moreover, the failure of healthcare professionals to comply should be grounds for job expulsion.  The General Medical Council UK supports this message by asserting that physicians should provide care under extenuating circumstances . 
Secondly, critics argue that healthcare is a solely humanitarian profession that healthcare workers acknowledge when entering the job field. Nonetheless, these physicians are expected to act uniformly across patients, not have the option on who to treat. Having a choice also raises issues of discrimination against patients in the workplace.  Many health frameworks recognize “the patient” as plural, implying that population health is dependent on the well-being of all components of society. Suppose healthcare workers refuse to treat patients who are infected, the well-being of the community as a whole decreases. For us to function collectively, we all must do our parts, which entails that doctors care for patients regardless of their circumstances. 
Similarly, opponents argue that this pandemic will not be the last. Healthcare workers should look at this as an opportunity to learn more about the next public health threat. Taken together, the work of a physician should not depend on the circumstance of the patient. Healthcare workers should have a duty to care for infected patients throughout the pandemic.
 Now that you have heard both sides, where do you stand: must healthcare workers care for infected patients even if it means putting themselves and their families at higher risk?
 
 
 
 
 


References:
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