Relational ethical approaches to the COVID-19 pandemic

David Jeffrey

Journal of Medical Ethics · 2020 · 81 citations · 9 references

DOIFull text

Open access

TL;DR

The COVID‑19 pandemic has highlighted key ethical challenges for healthcare workers, including isolation, social distancing, duty of care, fair access to treatment, and the needs of the poor and socially disadvantaged. The authors advocate a relational ethical framework centered on solidarity, relational autonomy, duty, equity, trust, and reciprocity. The paper examines relational autonomy, solidarity, reciprocity, utility, equity, and guideline‑based dilemmas around triage, do‑not‑resuscitate, and treatment withdrawal. The authors conclude by calling for broader discussion of relational ethics and envisioning a post‑pandemic future.

Abstract

Key ethical challenges for healthcare workers arising from the COVID-19 pandemic are identified: isolation and social distancing, duty of care and fair access to treatment. The paper argues for a relational approach to ethics which includes solidarity, relational autonomy, duty, equity, trust and reciprocity as core values. The needs of the poor and socially disadvantaged are highlighted. Relational autonomy and solidarity are explored in relation to isolation and social distancing. Reciprocity is discussed with reference to healthcare workers’ duty of care and its limits. Priority setting and access to treatment raise ethical issues of utility and equity. Difficult ethical dilemmas around triage, do not resuscitate decisions, and withholding and withdrawing treatment are discussed in the light of recently published guidelines. The paper concludes with the hope for a wider discussion of relational ethics and a glimpse of a future after the pandemic has subsided.

References

9