Ethical
challenges faced by medical sectors:
the
most critical dilemmas which are initiated till now are surged due to shortage
of important and necessary resources, mainly personal protective equipment
(PPEs) for clinicians working on the frontline and the emerging area of needing
to take highly critical decisions about which patient are in criteria to be
provided a limited supply of ventilators. The professionals are forcefully
making decisions under the cloud of huge uncertainty, we still lack accurate
data.
In
a large part of U.S, many like us, have never experienced such circumstances
where we can widely observe as optimal care in a simple manner is not feasible.
We are unable to practice in a manner that we have been doing so and this is
quite unsettling. But these are the measures required for us to do in time of a
pandemic when the requirement is more then our actual capacity How
should physicians’ approach each of these decisions? the decision making shouldn’t be only put in the
hands of physicians. They also require guidance from the upper level which
includes institutions, states or national bodies. The institution should make
the decision following the system procedure about the allotment of ventilator
which is quite a better solution regarding to an ethics perspective other then
leaving the situation in the hands of patient’s caretaker. Following the
procedures and instructions of a designated committee or institutional officer
to take the decision based on SOP guidelines helps understand that the
decisions taken are adequate and helps take the burden or guilt away from the
physicians and other workers who are working endlessly for the individual
patients diagnosed.
We
are aware that most of the institutions and states are updating their policies
according to the situation developed from what we know about COVID-19: others
are in development process. How can physicians deal
with the mental stress of making life-or-death decisions caused by equipment
shortages?
The idea that I have
discussed above regarding institutional protocols taking the decisions on
life-and-death which we are facing is the most impactful way to trigger
physicians deal with the ongoing uncertainty and toll in psychology of the
pandemic.
However, we are also
visualizing professional communities coming out with physicians discussing
concerns, Ideas and information on social media. Not only including clinicians
in their local institution or community, but going further state lines and
mostly internationally. They are providing support to the colleagues which is
very impactful.
This began as a testing
communication, but virtual activities are being created more systematically by
institutions and communities. Things like powering virtual town halls which are
able to connect the public with physicians in order to provide them support in
any way possible. The state in Colorado is initiating these virtual town halls
who introduce public state health experts who provide information and update
the citizens on the situation and answering the questions from physicians who
are practicing or retired.
With a shortage of PPE,
what ethical dilemmas do physicians face when it comes to caring for patients
who may be infected with COVID-19 but the doctors lack the proper equipment to
safely treat the patient? One of the agreements the physicians accepts on
joining the field is to accept personal risk which is far more then usual in
scenario of urgent need, which includes a event like an outbreak of disease.
With priority we’d ensure the production of top of the line personal protective
equipment because its very important to provide safety to the physicians
working on the front line against the pandemic and to meet ongoing needs of
health. If a shortage of PPEs occurs, physicians should be willing to accept
the scenario of suboptimal but safe protection until the supplies are back in
order
The job to substitute
PPEs are more like to provide ventilators or other supplies for patient use,
and like previously discussed all this decision should be initiated following
the set SOPs of the institutions and their protocol must be followed.
Analyzing on which
personnel is at most need for PPEs due to they are facing the most critical
risk looking after seriously ill COVID-19 patients have a justified claim to
protection available. There can be multiple ways to ensure protection to
physicians who are at high risk personally due to the reason of an underlying
medical condition. If they are given a task to give care to non-COVID-19
patients.
The institutions for
example are required to look for multiple ways for increasing the rate of
supplies of PPEs or analyze if PPEs can be re used by adequate sterilizing
until new equipment supplies are available, or need to dig out other ways to
ensure the requirement is full filled.
Fraud
triangle also endured due to its simplicity and accurate. Therefore a ACFE had
never stated this is the triangle which could also explain the various case of fraud.
Thus should be very careful when used the fraud triangle for the detail
analysis of PPE examples. The fraud triangle is very useful which is also help
to understand that in what way the people commit the fraud which is not the
scientific theory. Physicians also used the fraud triangle to undergo the
process of analyzing the damage if the think to not show up for work and they
have to understand that what impact will be done to their patients who are in
desperate need of them. In topic to provide safety to the members of the house
hold strict precautionary measures should be applied at their home. Many
physicians have young children or elderly parents at home. Is it ethical for
them to not show up for shifts at a hospital where COVID-19 is prevalent? How
should physicians keep their families safe while still meeting their ethical
obligations as a doctor?
I don’t have clear data
on how many physicians of our have families or household member who are
currently at high risk, but the information we do have is there are many of
these families out there. Maintaining an equilibrium between the professional
commitment to perform our duties which are urgently needed in a pandemic and
maintaining the responsibility of our household is tough.
There has been reports
of un-adequate hand sanitizers being sold and increase in their prices? The
reports surrounding the social media regarding the sale of un adequate
sanitizers are a matter of health department. They should look into the matter
on immediate basis because it will only create more problems for the health
workers to deal with and they should also go for the culprits who are
increasing the prices of their products during this epidemic.
This
is a big challenge since all all of the cases, because the system is unable to
cope with so many patients who need care as a result of the virus infection,
even if there is no other case related to heart problems or lungs or metabolic
diseases or cancer.
The
challenges vary from country to country but some things are emerging
everywhere. Didgital adoption for example have become disappointment for
everyone when they promised to give care and access digitaly. This year 2020
will not only remembered as the time of corona virus infections but also the
dodgial transformation time and where it became the mainstream solution.
History told us that it is difficult to put gennie back into the bottle once it
is out. This time is a clear example. Ther are many ways to cope with the
problem like use of technology in health care centers by linking the data from
labs to development of technological solutions to fastly relate it to testing
in many regions of the world. The use of telemedicine for care of the patient
directly for public health sectors have been described.
How
to cope with situation:
People
are experiencing variety of feelings and thoughts these days during this
situation of COVID-19. How to cope with this evolving situation so that it will
not spread a lot and will not affect our economy more. This is obviously be
stressful time for everyone. This is totally upsetting for everyone in this
world right now. Many of us are thinking that the world is about to end.
Students are bearing lose of their studies due to major lockdown. all people,
one who are affected, one who are watching media all over the world everyone is
in stress right now. Children especially are at the risk as they are
frightened. The image that was in their mind about the safe world is temporary
lost. We should talk with them and make them calm and seriously tell them the
protective measures.
A
lot of anxiety comes from not knowing what will happen regarding corona virus
outbreak and for how long the lock down will continue. We often experience paralyzing
anxiety. Accept that our life is going to be different for a while. Accepting
this situation will be really helpful. Even a well-off person is now worrying
about money and this stress is natural as the lockdown is impacting our economy
individually as well as globally.
Start
prioritizing your mental and physical health care. Stay aware about the latest
information regarding COVID-19 outbreak. Most people who become infected face
mild illness and can recover easily but can be more severe to some people
having weak immune system. Do following things to protect yourself and your
loved ones;
Wash
hands regularly and thoroughly with some alcohol bases hand wash or soap. This
can easily kill the viruses present on your hand
Maintain
at least 1 meter of social distance and anyone who is sneezing or coughing.
Because when someone sneeze or cough they put small liquid droplets from their
nose or mouth which may contain virus if you accidently breathe in those virus
containing droplets you will get the disease too.
Try
to avoid touching your own eyes, mouth or nose as our hand touch many surfaces
and can pick the virus. And once it transferred to eyes, nose or mouth, the
virus can sneak in the body and make ourselves sick.
Take
precaution about respiratory hygiene like putting on the mask on nose and mouth
and bet your elbow when cough or sneeze then throw the used tissue immediately.
If
you have any symptom regarding corona virus, seek the medical care as early as
possible.
Stay
informed and share advises regarding current situation to people around you
because together we can fight this disease to spread and together, we can save
our economy and ourselves.