Physician Health & Wellbeing — COVID-19 and Beyond
An Ethics Oasis in Our Pandemic Journey Come, be heard, you are not alone with the discomfort, we are here with you.
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patient rips off their mask, yelling at the doctor that COVID is a hoax. A masked doctor wonders if their nearly deaf patient, no longer able to read lips, really understands the procedure they consented to. In the hours prior to intubation, a COVID patient is not allowed to see their loved ones. A clinical team weighs one life against another to determine who receives ECMO when demand exceeds capacity. Healthcare workers are no strangers to moral distress, the painful experience of the gap between what we think should happen and what we can make happen. Since the arrival of COVID-19, we are getting toxic doses. How often do we wonder if we’re doing the right thing, or know we cannot? This comes at a time when we are increasingly distanced from the support of our colleagues — break rooms closed, masks covering our expressions, hugs not allowed. It’s enough to make anyone’s moral compass spin. One way to realign to our moral north star is to speak our experience. Our moral fibers, wounded by our experiences on the wards and clinics, can be strengthened by giving them voice. When we articulate out loud the conflict between how we want things to be versus how they actually are, we bolster our integrity and values. But who can we talk to? Our loved ones might not understand our work experiences. Coworkers are busy. What about HIPAA and liability issues? When By Mary Anderson, MD, Nancy O’Connor, MD and Joan Henriksen
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Winter 2021
Mary Anderson, MD
Nancy O’Connor, MD
we cannot air our thoughts, our struggles are compounded by loneliness. However, no caregiver is alone in experiencing ethical tensions. We are all familiar with that anguish in various ways, and that makes us uniquely qualified listeners. We ourselves are an underutilized community ready to support one another, if only we could find each other. In our organization, we created the Ethics Oasis to allow for that human connection. It is a twice a week meeting hosted online via Zoom. It lasts 50 minutes. No RSVP, special invitation, or registration is needed. It is open to all patient-facing caregivers. Topics of discussion are determined by those who attend. Conversations are confidential, peer-protected, non-judgmental, and moderated by an ethicist and a clinician. Participants voice their first-hand experiences of their ideals conflicting with their reality — all in the unique fellowship shared by healthcare workers. Ethics Oasis is not about critiquing care or performing an ethics consult. It’s not even meant for problem solving per
Joan Henriksen
se. We don’t have curriculum or didactic sessions. We ask that all speak solely from their own experience and avoid patient identifiers. All voices and perspectives are respected. We ask for presence — by minimizing distractions, using the video function of Zoom, and respecting silence as time for reflection. The Ethics Oasis model has many strengths. Being online, we are immune to social-distancing mandates. The online venue also dodges the challenges of finding physical meeting space. On Zoom we can see faces (with expressions, honesty, vulnerability) that are otherwise hidden by masks. We hope that attending from home lets participants feel safer and more comfortable, while also reducing the barriers of time and distance. We are pleased and gratified by the widespread support the Ethics Oasis has received across our organization. Ethics Oasis was initiated by a professional clinical ethicist with expertise in moral distress. Additional start-up energy came from the Clinical Care Committee, which
MetroDoctors
The Journal of the Twin Cities Medical Society
