BMA releases ethical guidance for doctors during COVID-19 outbreak

by Tim Tonkin

Guidance designed to support doctors’ ethical decision making during the COVID-19 pandemic has been published by the BMA.

Location: UK
Published: Thursday 2 April 2020
Depiction of molecular virus

Legal and ethical guidelines around how doctors should respond to the virus outbreak has been put out amid warnings pressure on staff and the NHS is likely to grow.

In its guidance, the association warns the clinical demands likely to be posed by the pandemic will inevitably require doctors to have to make extremely difficult choices about how they provide care to patients.

The document highlights how the demands placed on the health service at the peak of the pandemic will see doctors and other healthcare staff being required to move away from their usual roles to help meet patient demand.

The guidance also warns that, with the NHS having little to no surge capacity, ‘serious health needs may outstrip availability and difficult decisions will be required about how to distribute scarce life-saving resources’.

Mental wellbeing

It outlines the responsibility of employers to doctors during the pandemic, specifically the need to ensure and support staff’s mental wellbeing at a time of extraordinary clinical pressure and patient demand.

There is further emphasis on how doctors who believe they are being asked to subject themselves to unacceptable personal risk owing to inadequate or a lack of PPE (personal protection equipment), have a right to raise these concerns, adding that employers have ‘a legal and ethical responsibility to protect their staff’.

It says: ‘Health staff, and other staff essential to the running of health services cannot be expected to expose themselves to unreasonable levels of risk where employers have not provided, or have been unable to provide, appropriate protective equipment.

‘In the BMA’s view, there are limits to the level of risks doctors can reasonably be expected to expose themselves to as part of their professional duties.’

It adds: ‘Doctors would not be under a binding obligation to provide high-risk services where employers have failed to fulfil at least minimal obligations to provide appropriate safety and protection and to protect doctors and other health professionals from avoidable risks of serious harm.’

Equipment pledge

Since the start of the COVID-19 outbreak, many reports about deficiencies in PPE while treating patients have been reported in the media.

In response, the Government announced on 29 March that it had established a nationwide team that would distribute millions of masks, gloves, aprons and eye protectors to trusts across the country. However, many doctors continue to warn that they are having to work in unacceptably high-risk conditions.

A framework originally published by the Government’s committee on ethical aspects of pandemic influenza in 2007, subsequently revised by the Department of Health and Social Care in 2017, outlines its own guiding principles.

This includes the concept that everyone matters equally and deserves equal respect while acknowledging this does not mean everyone is treated the same.

Read the Government’s ethical framework