PHYSICIANS' MORAL DUTIES DURING PANDEMICS

Kenneth V Iserson; Arthur R Derse; John C Moskop; Joel M Geiderman

doi:10.1016/j.jemermed.2023.02.009

PHYSICIANS' MORAL DUTIES DURING PANDEMICS

J Emerg Med. 2023 Jun;64(6):740-749. doi: 10.1016/j.jemermed.2023.02.009. Epub 2023 Mar 21.

Authors

Kenneth V Iserson¹, Arthur R Derse², John C Moskop³, Joel M Geiderman⁴

Affiliations

¹ Department of Emergency Medicine, The University of Arizona, Tucson, Arizona; Department of Emergency Medicine, Institute of Health Science Education, University of Guyana, Georgetown, Guyana.
² Julia and David Uihlein Chair in Medical Humanities, Department of Bioethics and Emergency Medicine, Center for Bioethics and Medical Humanities, Department of Emergency Medicine, and Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee, Wisconsin.
³ Wallace and Mona Wu Chair in Biomedical Ethics, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
⁴ Department of Emergency Medicine, Ruth and Harry Roman Emergency Department, Cedars-Sinai Medical Center, Los Angeles, California.

Abstract

Background: Pandemics with devastating morbidity and mortality have occurred repeatedly throughout recorded history. Each new scourge seems to surprise governments, medical experts, and the public. The SARS CoV-2 (COVID-19) pandemic, for example, arrived as an unwelcome surprise to an unprepared world.

Discussion: Despite humanity's extensive experience with pandemics and their associated ethical dilemmas, no consensus has emerged on preferred normative standards to deal with them. In this article, we consider the ethical dilemmas faced by physicians who work in these risk-prone situations and propose a set of ethical norms for current and future pandemics. As front-line clinicians for critically ill patients during pandemics, emergency physicians will play a substantial role in making and implementing treatment allocation decisions.

Conclusion: Our proposed ethical norms should help future physicians make morally challenging choices during pandemics.

Keywords: COVID-19; Pandemics; crisis standards of care; emerging infections; health care equity; professionalism; resource scarcity; triage.

MeSH terms

COVID-19* / epidemiology
Humans
Moral Obligations*
Pandemics
Physicians*
Triage