Healthcare Ethics During a Pandemic Xavier Symons is a Lecturer in the Institute for Ethics and Society at the University of Notre Dame Australia. He will be completing his 2020 Fulbright Future Postdoctoral Scholarship at the Kennedy Institute for Ethics (KIE), Georgetown University. He recently completed a PhD on the ethics of healthcare resource allocation.
DR XAVIER SYMONS, Fulbright Future Scholar (Healthcare Ethics/University of Notre Dame)
How has COVID-19 affected your day-today life?
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The COVID-19 pandemic has led to some fairly radical changes in my life. Last month I had to self-isolate for two weeks after returning from a trip to Oxford, and, like most people, I’m now working from home. I work for a research institute at the University of Notre Dame, and we’ve had to completely readjust our 2020 calendar. As part of my work, I organise regular seminars on ethics in social and professional life. Most of our upcoming events, however, have been postponed or cancelled. There’s even a possibility that I may have to delay the start date of my residency at the KIE. I’m slowly adjusting to several hours a day of teleconferences, and getting used to instant coffee rather than heading to my favorite cafes. But perhaps there’s a silver lining to the solitude of the current situation. I’m an ethicist with a background in moral philosophy. And many of the great philosophers wrote their best work while on retreat in the countryside or in front of the fireplace at home. Who knows, maybe the next few months may be more productive than I’m anticipating.
What are some of the ethical challenges that decision-makers could face in the coming months? Culturally-speaking, how does Australia typically respond to these challenges? Ethics is always relevant to life, even when it’s business as usual. But ethical reflection is particularly important during a crisis such as the current COVID-19 pandemic. One issue that I’ve written about recently is the ethics of healthcare resource allocation during a pandemic. ICU physicians in countries like Italy, France, the UK and the US are being forced to ration precious resources like ventilators as their wards are overwhelmed by critically ill coronavirus patients. These rationing decisions raise a number of complex ethical questions. For example: Is it permissible to ration health care on the basis of age? How can we obtain maximal benefit from healthcare resources while not discriminating against people with disabilities? And should people with important social and political roles (such as healthcare workers and politicians) receive priority access to scarce resources? Rather than having to face these agonising ethical questions, Australian authorities have sought to “flatten the curve” through aggressive social distancing measures. Current modelling suggests that this strategy is working. Culturally, I think that Australia’s response to the pandemic reflects a sense of solidarity with society’s most vulnerable. State and Federal Governments have made minimising loss of life their primary priority. I think this is a laudable approach, and one that gives due importance to the value of each human life. It’s also important to note that the risk of burnout for clinicians is heightened in a time of crisis, and so healthcare professionals must be given adequate time off during the coming months. Patients are put at risk when they are being treated by a clinician who is on the verge of a breakdown. In this sense, burnout and fatigue become ethical issues.
