[vc_row][vc_column][vc_column_text]The 2019–2020 coronavirus pandemic is upending life on a global level as we know it. The highly infectious coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first seen in Wuhan, Hubei, China where its outbreak was first identified in December 2019. After almost 3 months, on March 11, 2020, the World Health Organization recognized it as a pandemic considering its significant ongoing spread in multiple countries across the world.
As of April 11, 2020, approximately 1,741,621 cases of COVID-19 have been confirmed in over 210 countries and territories resulting in around 106,670 deaths. Clearly, the corona virus outbreak situation cannot be taken lightly. Global pandemic of COVID 19, its ophthalmic implications, and precautions are nicely summarized in recently published editorial.
Doctors, Health-care Workers and Fight against COVID-19
Needless to say, doctors, nurses and people working in health-care sectors are particularly vulnerable to the highly infectious disease. In response to the global pandemic, the under-resourced doctors are facing unprecedented challenges. The list of the sleep-deprived heroes includes doctors, nurses, medical cleaners, pathologists, paramedics, ambulance drivers, and health-care administrators. In the fight against coronavirus, the brave medical army stands strong with thermometers, stethoscopes, and ventilators as their weapons. Not to forget, medical researchers are working day in and night out against all odds, hoping to find the antidote to the disease.
Since the coronavirus outbreak, health-care professionals have not only experienced the gratification of healing patients and saving their lives but have also lost many battles along the way. On top of that, many doctors have even sacrificed their own lives in the line of duty.
Every day, the selfless warriors are giving it their all in health-care settings while cutting themselves off from their families and loved ones. The sacrifice that they are making for the safety and welfare of humanity is priceless and deserves lifelong gratitude on our end. Most importantly, we must reassess the value health-care workers hold in our lives and the kind of treatment they get from us. Among the several lessons this coronavirus pandemic has been teaching us, the biggest one is to find ways to sufficiently invest in the better and more efficient medical fraternity and give medical professionals the respect, compensation and infrastructure that they truly deserve once this crisis is over. Moreover, the world needs to work towards advancement in medical research and technology. Nothing will be a greater tribute to the health-care workers than this.
That being said, we’d now like to highlight the heroic efforts of some courageous and inspiring doctors from across the globe who lost their lives while saving the lives of COVID-19 patients.
Abstract
Doctors form an essential part of an effective response to the COVID-19 pandemic. We argue they have a duty to participate in pandemic response due to their special skills, but these skills vary between different doctors, and their duties are constrained by other competing rights. We conclude that while doctors should be encouraged to meet the demand for medical aid in the pandemic, those who make the sacrifices and increased efforts are owed reciprocal obligations in return. When reciprocal obligations are not met, doctors are further justified in opting out of specific tasks, as long as this is proportionate to the unmet obligation.
Doctors form an essential part of an effective response to the COVID-19 pandemic. They have critical roles in diagnosis, containment and treatment, and their commitment to treat despite increased personal risks is essential for a successful public health response.1 Frontline workers have been experiencing high work volume, personal risk and societal pressure to meet extraordinary demands for healthcare. Despite this traditional public health ethics has paid little attention to the protection of the rights of doctors.
We will consider the role of doctors during the COVID-19 pandemic, focusing primarily on the British National Health Service (NHS), by answering the following four questions: what is the nature and scope of the duties of healthcare providers? To whom do these duties apply? What reciprocal obligations to doctors exist from their employers and patients? And what should doctors do when these reciprocal obligations are not met?
Do doctors have a duty to treat in disease outbreaks and pandemics such as COVID-19?
With respect to moral theory, numerous grounds have been offered for the view that doctors have a duty to treat or an obligation to provide care to patients.With regards to pandemics, claims about the duties of doctors are most often grounded in so-called ‘special duties’ or ‘role related’ duties. In other words, by virtue of their profession, doctors have more stringent obligations of beneficence than most, and they have obligations to a specified group of persons (their patients) that non-medical personnel have no obligation to help.Clark argues that the duty can be justified with reference to: special skills possessed by healthcare professionals, which mean that they are uniquely placed to provide aid, thereby increasing their obligation; the individual’s freely made decision to enter the profession with the knowledge of what the job entails and the nature of the associated risks; and the social contract between healthcare professionals and the society in which they work. However, it seems clear that the duty to treat cannot be ‘absolute’—that doctors have a duty to work regardless of the circumstance. Doctors have rights to protection and to care during an infectious disease outbreak, as do other members of society.
Special circumstances
Emerging threats of infectious diseases such as COVID-19 demand much more than that doctors continue to work as normal. Pandemics may necessitate longer hours (and corresponding increased exposure to the virus), potential quarantines and assignments outside one’s normal specialty. What distinguishes normal duty from acting beyond the call of duty is not always clear-cut. However, experience so far suggests that in the current epidemic doctors are subject to risk of illness, risk of death,fatigue from extended hours, moral distress (when being party to difficult treatment decisions, such as prioritisation of patients for ventilators) and potential legal and professional risks when be asked to work at the limits of their competencies.
Adhere to precautions
Manage visitor access and movement
Create procedures for monitoring, managing and training visitors. For known or suspected patients with COVID-19, physicians and other health professionals should restrict visitors from entering the room. Alternative options for interactions between patient and visitor include video-call applications on mobile devices or tablet computers.
Implement engineering controls
Health care organizations should also consider designing and installing engineering controls to reduce or eliminate exposures by shielding physicians, other health professionals and patients from infected individuals. For example, physical barriers or partitions can help guide patients through triage areas.
Monitor and manage health personnel
For physicians and other health professionals who are ill or exposed to 2019-nCoV, movement and monitoring decisions should be made with guidance from public health authorities. When providing care to patients with COVID-19, health care organizations and facilities should implement sick leave policies that are nonpunitive, flexible and consistent with public health guidance.
Train and educate health professionals
Everyone should be provided with job- or task-specific education and training on preventing transmission of infectious agents prior to caring for a patient. Whenever respirators are required, all health professionals must be medically cleared, trained and fit-tested for respiratory protection device use.
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