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Masking emotions & sterilising care: ‘reset’ ethics and the unintended consequences of COVID-19

The coronavirus (COVID-19) pandemic has caused far-reaching consequences for health systems worldwide. In responding to the pandemic, decision-makers have to balance competing interests and difficult trade-offs have to be made. We are told that Government guidance continues to ‘follow the science’, but such guidance must also be values-based. Transparency in the values that underpin those decisions is crucial to support healthcare decision-makers and frontline practitioners during a pandemic, as well as to build public understanding and support for the balances struck.

Pandemics—and public health emergencies more generally—reinforce approaches to ethics that emphasise, or derive from, the interests of communities. Accordingly, in the acute phase of the coronavirus pandemic, attention was focused on saving as many lives as possible. The main focus of discussion was on infection prevention and control measures, and the approach that should underpin resource allocation between patients with COVID-19 in the event that demand for life-saving equipment were to outstrip supply. Guidance on ethical responses to the acute phase of a pandemic is readily available. In the UK, for example, the Pandemic Flu Ethical Framework was available to guide decision-making.

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A Human Rights Perspective on COVID-19 Triage

Covid-19 has forced governments and healthcare workers around the world to make difficult and painful decisions about whose care to prioritise and how. Arts and Humanities researchers provide vital insight and scrutiny into the ethical dimensions of these decisions. In this blog post Dr Vivek Bhatt, Postdoctoral Research Associate for the AHRC-funded project ‘Ensuring Respect for Human Rights in Locked-Down Care Homes’, outlines some of the findings of the Essex Autonomy Project’s work investigating triaging decisions from the perspective of human rights.

By Dr Vivek Bhatt, 10th May 2021

The COVID-19 pandemic has seen many hospitals around the world run out of ICU beds and critical supplies such as oxygen, with frontline workers forced to decide who should be prioritised for potentially life-saving treatment. This decision-making process is referred to as ‘triage.’ The practice of triage began during the Napoleonic wars and developed further during the two world wars, with the implementation of systems for sorting and prioritising wounded soldiers for treatment. As recent events have shown, triage decisions are equally difficult, and just as often painstaking, in the context of COVID-19. In Ontario, Canada, a spike in ICU admissions for COVID-19 treatment may soon force doctors to activate triage policies that provide a matrix for deciding who should be allocated the few remaining ICU beds in the province. And hospitals in India, where oxygen is in short supply, have set up ‘war rooms’ in which clinicians try to decide who should be prioritised for ventilation.