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The Ethical Dilemmas of COVID-19

The Ethical Dilemmas of COVID-19

It is not easy to be a nurse; it is a job that requires you prioritize the needs of others.

Because in nursing human lives are at stake, the ethical considerations are substantial. The

variations in morals and priorities among both patients and nurses make ethical decisions

intrinsically nuanced. Due to the gravity of the ethical dilemmas’ nurses face, the career as a
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whole has done it’s best to empower nurses by instituting a nursing code of ethics, as well as

setting up ethical committees in hospitals. That being said, in our ever-changing world, there are

new ethical dilemmas each day. In 2020 the COVID-19 outbreak shook the world. When

pandemics occur, there is an obvious burden placed on healthcare workers. As a nurse is it

ethical to work during a pandemic and put your family at risk? Is it ethical to abstain from work

and prioritize yourself over your patients? These questions do not have a clear-cut answer, but

one is forced to make a decision.

This year the world had confront a global pandemic, an occurrence that was, in a

practical sense, unforeseen. The outbreak of COVID-19 has been a surreal experience for many.

Having to isolate and quarantine from family, friends, and if you live alone, potentially all

human contact. Humans are considered to be social primates. It is widely believed that the

human species has adapted to be social by benefitting from the advantages of having a diverse

group working towards common goals such as protection, attaining sustenance and protection for

vulnerable members. These adaptions are likely responsible for the endogenous opioid response

that is correlated with touch, laughter, and bonding between humans. (Sakman,2020). When you

get a social species and isolate them, it unsurprisingly elicits a stress response. In one poll it was

reported that 45% of Americans reported a negative impact on their mental health due to

COVID-19 (Khubchandani et al., 2020).

While this is a stressful time for many, healthcare workers are on the front lines. Nurses

see first-hand the toll the pandemic has taken. They have had to watch patients die in isolation.

They have had to call family members to inform them that their loved ones will die and that they

cannot see them before they pass. Health care personnel have stress from the circumstances of

their job, as well as the fear of bringing home illness to their loved ones. High risk personnel
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have reported higher rates of fear and anxiety regarding COVID-19, as opposed to low risk

health care workers. (Khan et al., 2020) There can also be a stigma associated with working in

the healthcare setting during an outbreak of an infectious disease. One study in Singapore

reported 49% of health care workers experienced social stigmatization during the SARS outbreak

(Van der Scheun at al., 2019). This stressful climate can lead to healthcare workers opting to stay

home during such times.

While it is obvious why a nurse may want to stay at home during a pandemic, is it ethical

to do so? In the nursing code of ethics Provision 2 reads, “The nurse’s primary commitment is to

the patient, whether an individual, family, group or community.” (Taylor et al., 2018) Now after

reading this provision one may ascertain that the obvious ethical decision as a nurse would be to

work. But, not so fast because in Provision 5 it states, “the nurse owes the same duties to self as

to others, including the responsibility to preserve integrity, to maintain competence, and continue

personal and professional growth.”(Taylor et al., 2018) So, while the nurse is obligated to their

patients, they are obligated to give the same level of care to themselves. While these provisions

are both important, they leave room for an ethical dilemma. In nursing ethical decision making

for conundrums of this sort includes a five-step process: assess, diagnose, plan, implement, and

evaluate.

The first step is to assess the facts. Gather pertinent data about the current situation.

Then identify the problem; is it more ethical to work or abstain during a pandemic. The planning

step is easier said than done. Planning includes weighing the alternatives. This step is where the

nuance comes in. No two people have identical circumstances and one has to assess their own

values and morals. Nurses are constantly establishing priorities on the job, and that is precisely

what must be done here. If one were to decide that working was the ethical decision, they would
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have to take into account their family, are there high-risk individuals they could be endangering?

They need to assess their own mental health; can they stand being away from friends and family

to protect them from possible infection? If one decides that not working is the right course, they

need to consider if they can afford to stay home financially. Also, there is the mental toll of

being removed from their routine and career. There may be career implications varying from

judgment from peers to permanently losing their position. One must look within and truly

analyze themselves. After the introspection it is time to implement. Whatever decision is made

it is time to act upon it. And lastly one can evaluate the outcomes. Hindsight is 20/20 and it may

be difficult to look back and realize a mistake has been made. While it is difficult, it is crucial

for growth. One must learn from their experiences whether good or bad.

Ethical decision making is difficult. If it were easy everyone would always do the right

thing and there would be no question. That is obviously not the case as our world is not black

and white. Issues concerning health are always going to be complicated because they have to do

with personal motivation, obligation to others, and cultural views. Though not easy to

implement, ethics are vital, especially to healthcare. While life is to be enjoyed, it should not be

taken lightly. The COVID-19 pandemic has helped many people to realize what their priorities

are or to set new ones. It will be crucial to evaluate the outcomes and learn from the inevitable

failures and successes of this unique time in history.

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References

Khan, K. S., Mamun, M. A., Griffiths, M. D., & Ullah, I. (2020). The mental health impact of the

COVID-19 pandemic across different cohorts. International Journal of Mental Health

and Addiction, 1-7.

Khubchandani, J., Kandiah, J., & Saiki, D. (2020). The COVID-19 Pandemic, Stress, and Eating

Practices in the United State

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Sakman, E. (2019). Humans as Social Primates. Accessed via

https://www.researchgate.net/profile/Ezgi_Sakman/publication/338537340_Humans_as_

Social_Primates/links/5e1a684da6fdcc28376ba474/Humans-as-Social-Primates.pdf

Taylor, C., Lynn, P., & Bartlett, J. (2018). Fundamentals of nursing: The art and science of

person-centered care. Lippincott Williams & Wilkins.

Van der Scheun, F. C., Nagelkerke, M. C. M., Kilaru, A., Shridhar, V., Prasad, R., & Van der

Werf, T. S. (2019). Stigma among healthcare workers towards hepatitis B infection in

Bangalore, India: a qualitative study. BMC health services research, 19(1), 736.