DUTY OF CARE

During a pandemic, there are thousands of frontline healthcare providers being called to care for infected patients, placing their own health and lives at risk. Because healthcare providers are critical to an effective response during a pandemic, it is important for them to be aware of the rights and responsibilities around caring for patients during a pandemic.

Duty of care is defined as the ethical and legal responsibility of a person or organization to avoid any behaviors or omissions that could reasonably be foreseen to cause harm to others (LD, 2017). Healthcare professionals have an ethical duty to provide care. They have an obligation to treat all patients and are not at liberty to abandon them.

Considerations during a pandemic involve weighing the potential harm to a healthcare worker against the potential benefit to a patient. Where risk to the worker is low and benefit to the patient is high, the duty of care obligation increases. However, where the risk to the healthcare worker is high and the benefit to the patient is low, the obligation to care for the patient decreases.

Governments and healthcare employers also have duties and obligations to healthcare professionals. They have a responsibility to ensure safe working conditions, including making certain there are appropriate safety precautions in place to protect those healthcare providers and to ensure that counseling and mental health supports are in place during such a crisis (Gruben & Czarnowski, 2020).

There are also limits to the personal risk of harm that healthcare personnel can be expected to accept as an ethical duty. Harm includes emotional, psychological, physical, or spiritual. Balancing their professional demands with the need to protect and care for self and family may therefore introduce a dilemma. Some may feel the personal risks are too great and choose not to care for infected patients. When this happens, the effects on the healthcare system could be profound.

An American Nurses Association “Position Statement” (2015) indicates that caring for an individual with an infectious disease that places a healthcare worker at risk of harm is considered a duty rather than an option if all of the following four criteria are met:

1. The patient is at significant risk of harm, loss, or damage if the healthcare worker does not assist
2. The healthcare worker’s intervention or care is directly relevant to the prevention of harm
3. The healthcare worker’s care will probably prevent harm, loss, or damage to the patient
4. The benefit the patient will gain outweighs any harm the healthcare worker might incur and does not prevent more than an acceptable risk

Nurses must balance their perceived duty to care against their perceived risk of harm to determine their willingness to report during a pandemic or other disaster event, potentially creating an ethical dilemma and impacting patient care. Nurses have both an ethical and a moral obligation not only to care for others but also to care for themselves. Moral considerations are subjective and vary with each individual (McNeill et al., 2020).