The Royal College of Physicians’ (RCP) Committee on Ethical Issues in Medicine, of which Dr Lucy Frith from the University’s Institute of Population Health Sciences is a member, has issued their ethical guidance for frontline staff dealing with the COVID-19 pandemic. The guidance is supported by nine other Royal Colleges and five medical faculties.
The guidance is based on the principle of fairness and sets out criteria for decision-making to help frontline staff make ethical decisions. Decision should be based on the principles of: accountability, inclusiveness, transparency, reasonableness and responsiveness.
Fair and equitable
The guidance stresses that: ‘while so much has changed during the pandemic, frontline staff still need to ensure that care is provided in a fair and equitable way.’
The guidance states that the presence or absence of COVID-19 should not be a limiting factor in treatment decisions. Where care between a patient and a COVID-19 patient in need of care is in question, care should be prioritised based on national guidance.
Decisions should be made, regardless of whether they are COVID-19 related, should be done according to protocol, as per good clinical practice. Accountability remains unchanged and such decisions should be robustly documented.
The RCP’s guidance reminds doctors of the importance of discussing with patients directly and their carers their wishes regarding ongoing care, and, again, these decisions should be clearly recorded.
Right to protection
Doctors, as well as having a duty to protect the public from harm, have a right to protect themselves so that they can continue to care effectively, and it would be ethical for those who would be harmed by contracting COVID-19, including doctors aged over 70 or with underlying health conditions – as per the government’s guidance – to refrain from treating patients with (or suspected to have) the virus. They should instead take on duties away from high risk areas.
Dr Lucy Frith, Reader in Bioethics & Social Science, Institute of Population Health, said: “It is important to have national guidance on how to approach the many difficult ethical decisions that will need to be taken during the Covid-19 pandemic and these guidelines give clinicians across specialities resources to help them navigate this unprecedented public health emergency.”
The full text of the guidance can be found here.