Coronavirus raises ethical questions for health care providers

Ethics is in the news these days more than ever.

You can’t read a newspaper, listen to the radio, or watch television news without encountering profound moral issues, made more difficult during the times in which we live with the COVID-19 virus. And sometimes there are no quick and easy answers, even though we wish there were. Most of us muddle through, hoping to do the best we can but never completely realizing the consequences of our choices.

The first ethical issue that caught my attention was a story about a Texas church deciding to hold Sunday services against the advice of health professionals who noted the virus is passed easily when people meet in groups. The church claimed religion was a necessary service and their right under the constitution. Others said this was not a case of religious freedom but of public safety, noting that the congregation was not only endangering its members but spreading the virus to others who were not members.

A dominant moral issue in several cases had to do with rationing of goods or services, most often the issue focused on this question: What do you do if there is not enough protective gear to go around to hospital staff? Without a national stockpile, hospitals and states ended up competing against one another and sometimes even against the federal agency responsible for distributing protective gear.

Then there’s the ethical decision about rationing care for patients when there are not enough ventilators or intensive care beds. How do you decide among those hospitalized? Do you choose young patients over old, the most common choice? What if the younger patient is in worse shape than the older, or if the older patient is a retired physician volunteering to serve others?

Another developing issue: How do you ration food if supplies are limited? Do you permit only limited quantities to each customer or only ration supplies in short supply? Do you give preference to certain individuals, perhaps those most in need of food?

I have found there are three great moral traditions that offer guidance when faced with ethical choices.

The most prominent theory is called situational ethics, which believes there are no hard and fast rules. Every situation must be judged on its own merits. A second more commonly used theory.is utilitarianism whose essential principle is to focus on the solution that produces the greatest good for the greatest number of people. The third theory is called Kantian ethics with a central principle called the categorical imperative. It bases moral choices on what is called the categorical imperative, which has two dimensions. First, whatever choice is made, it must be good for everyone, not just oneself or one’s group. And second, human beings should be treated as ends unto themselves, not as means to some other group.

There are three ethical questions I use to help before making a decision: Are there any rules or principles to guide your decision? What’s best for the person or people involved?

What’s the best you can do in the situation?

And one final, very important ethical principle: if you don’t take care of yourself no one else will. It is not selfish to do so, rather self-care. Focus on what you can change, not what you can’t. Practice taking time for quiet reflection, prayer, mindfulness.