- Researchers are highlighting the need for bioethics research in the face of the pandemic.
- From moral crises in healthcare workers to personal freedoms - does reality match up with our perceived ethics?
- These kind of studies will be useful for decision making in similar future scenarios.
Since Covid-19 became a serious threat to global health, researchers and scientists have been scrambling to find out as much as possible about the deadly disease, pushing through studies at high speed.
This research is critical in the fight against the coronavirus, and it's important that these studies are shared across the world to help develop treatment and vaccines faster in order to save lives.
But perhaps it's time to take a brief step back and look at the bioethics of these studies undertaken in such stressful times, as well as the ethical frameworks involved in on-the-ground decision making.
Bioethics with empirical evidence
Nursing researchers - Connie Ulrich from the University of Pennsylvania, Emily Anderson from the Stritch School of Medicine and Jennifer Walter from the Children's Hospital of Philadelphia - wrote an editorial in AJOB Empirical Bioethics about the need for constructive bioethics research amid the flurry of Covid-19 studies.
"As bioethicists aim to contribute to conversations about what should be done to keep us all safe and healthy, ethical frameworks are applied to these novel circumstances to aid in ethical decision making, such as triage protocols, human challenge studies, and immunity passports," write the researchers.
Bioethics research needs to go hand-in-hand with empirical evidence to accept and reject various approaches to the pandemic, based on real-life scenarios, to better help global decision making when it comes to the virus.
Ethical dilemmas of frontline workers
Understanding why these decisions are being made can also help to shape future healthcare and better understand the difficulties faced by frontline workers, especially those who are vulnerable themselves or have family members who are.
"What do they see as the limits of their professional and ethical obligations? Do they believe they must perform their jobs in the face of significant risk? How do they define 'appropriate risk' and how should it be defined? And what do they think are the ethical obligations of their employers?
"In defining the potential limits of professional duty and the duty to care, empirical research can help refine the issues, particularly as they affect healthcare and non-healthcare professionals."
These ethical dilemmas are also influenced by the moral distress that healthcare providers face in this time, when hospitals are overwhelmed and they have to choose between who lives and dies with scarce resources, even putting themselves at risk without much-needed protective gear.
"The 'rightness or wrongness' of a decision may haunt a healthcare worker for years to come."
This moral distress unique to a pandemic also needs to be acknowledged in bioethics research in order to develop better coping mechanisms and mitigate long-term effects on healthcare workers' mental health.
These studies need to back up the ethics with empirical findings, comparing the hard numbers with our perceived ethical norms and seeing if they actually match up.
Some examples include examining prejudicial biases when it comes to triage decisions and the real benefits and disadvantages of relying more heavily on artificial intelligence in healthcare.
Ethics in vaccine research
Then there are the ethics of Covid-19 research itself - how research subjects and their families are approached, how respect is maintained and whether it's ethical to knowingly expose a subject to the disease in order to test potentially life-saving treatment.
"However, a grassroots movement of individuals who want to volunteer to participate in human challenge studies has the bioethics community considering whether informed volunteers should be allowed to take on more risk than is normally allowed, and if so, with what precautions?"
This movement - called 1 Day Sooner - advocates for trials where human subjects are purposefully exposed to the virus in an effort to speed up vaccine and treatment trials. It's centred on creating a database of volunteers from around the world willing to risk their health to help fight the disease.
But these studies aren't just about the ethics of frontline workers and research, they're also about the responsibilities and individual rights of the average person.
This comes into play when considering vaccine hesitancy, especially if it hasn't been fully tested for safety and the greater good, as well as privacy concerns in terms of contact tracing and freedom of movement in government-mandated lockdowns.
In the end, it comes down to individual freedoms versus the collective good and the ethics behind each decision.
"Any empirical bioethics research undertaken should be meaningful - and should therefore meaningfully engage a broad range of institutional leaders, clinicians and researchers, and patients and citizens.
"Better understanding the experiences, views, values, and expectations of stakeholders across diverse communities can ensure that the bioethics community - along with policymakers, public health and healthcare systems, and research institutions - is better prepared during the months and years that lie ahead as we tackle the problems raised by Covid-19 and for future pandemics."
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