Attaining the Quadruple Aim of Worker Well-Being in the COVID-19 Crisis: Competing Ethical Priorities

Richard A. Culbertson, PhD, MHA, MD

Abstract


The COVID-19 pandemic presents ethical challenges to health care organizations and society as a whole regarding protection from a lethal communicable disease. In traditional medical ethics, we make an appeal to the duty of the professional to serve in the face of personal peril. At the same time, health care organizations are obligated to furnish protective equipment and provide a safe workplace in order to mitigate risk. The ethical calculus of utility, or greatest good for the greatest number, supplies some guidance in situations of scarce resources by sustaining as large a presence of front line workers through prevention or therapeutic intervention to combat disease. Determinations of utility do not absolve health care organizations of a duty to protect and avert future crises through better planning. A misguided pursuit of efficiency has resulted in excessive burden of risk for health workers providing direct patient care and for workers in supporting roles. There is an important duty to plan to lessen such risk in future pandemics.

Keywords: COVID-19, hospital, ethics


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