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2020 ; 46
(7
): 436-440
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Your country needs you : the ethics of allocating staff to high-risk clinical
roles in the management of patients with COVID-19
#MMPMID32409625
Dunn M
; Sheehan M
; Hordern J
; Turnham HL
; Wilkinson D
J Med Ethics
2020[Jul]; 46
(7
): 436-440
PMID32409625
show ga
As the COVID-19 pandemic impacts on health service delivery, health providers are
modifying care pathways and staffing models in ways that require health
professionals to be reallocated to work in critical care settings. Many of the
roles that staff are being allocated to in the intensive care unit and emergency
department pose additional risks to themselves, and new policies for staff
reallocation are causing distress and uncertainty to the professionals concerned.
In this paper, we analyse a range of ethical issues associated with changes to
staff allocation processes in the face of COVID-19. In line with a dominant view
in the medical ethics literature, we claim, first, that no individual health
professional has a specific, positive obligation to treat a patient when doing so
places that professional at risk of harm, and so there is a clear ethical tension
in any reallocation process in this context. Next, we argue that the changing
asymmetries of health needs in hospitals means that careful consideration needs
to be given to a stepwise process for deallocating staff from their usual duties.
We conclude by considering how a justifiable process of reallocating
professionals to high-risk clinical roles should be configured once those who are
'fit for reallocation' have been identified. We claim that this process needs to
attend to three questions that we consider in detail: (1) how the choice to make
reallocation decisions is made, (2) what justifiable models for reallocation
might look like and (3) what is owed to those who are reallocated.
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