When pandemic and everyday ethics collide: NHS Reset Ethics [COVID-19]

• Research type

  Research Study

• Full title

  When pandemic and everyday ethics collide: supporting ethical decision-making in maternity care and paediatrics during the Covid-19 pandemic

• IRAS ID

  287856

• Contact name

  Lucy Frith

• Contact email

  frith@Liverpool.ac.uk

• Sponsor organisation

  University of Liverpool

• Duration of Study in the UK

  0 years, 11 months, 18 days

• Research summary

  Research Summary:
  This project focuses on how the response to Covid-19 has created significant ethical issues for providers of non-C19 services when deciding how to prioritise and reconfigure services. Our central aim is to evaluate and support clinical decision-making in two non-C19 areas: maternity and paediatrics.

  Objectives:
  1.Conduct a rapid review of current local policies and policy-making processes for clinical decision-making in non-C19 maternity and paediatric services.
  2.Examine how the policies are applied in clinical practice, and test approaches to ethics support.
  3.Make recommendations for clinical ethics support at local policy-making and practitioner levels; and develop tools to support good decision-making practice. This is an empirically informed ethical analysis of current policies, processes and clinical practice in non-C19 maternity and paediatrics.

  Methods overview:
  rapid review of local policies and decision-making processes for clinical practice during the C19 pandemic and recovery phases; analysis of the values being engaged. Interviews and focus group discussions with key stakeholders involved in policy formation, members of the public and healthcare practitioners to understand how the policies are being applied in clinical practice and what support they might need in their ethical decision-making. Developing and piloting mechanisms of ethics support.

  Lay Summary of Results:
  - Healthcare professionals have lacked structured ethical support in managing the unique public health/clinical ethics tensions characterising the reset phase. Refusing to allow exceptions to strict infection prevention measures risks moral damage to healthcare professionals as well as trauma to patients and their families.
  - Treatment delivered in accordance with infection prevention measures can largely attain ‘functional equivalence’, but it is difficult for healthcare professionals to offer treatment that feels caring. Where their inability to offer demonstrable care goes against their deeply held personal and professional values, this opens the door to moral distress and moral injury. Patients understand the need for infection prevention, but wonder if the balance is right.
  - The usual mental health, wellbeing and ‘moral distress’ support and coping mechanisms are not helping healthcare professionals manage. The vaccination roll-out has not been the anticipated light at the end of the Covid-19 tunnel. There is a damaging disconnect between the ongoing crisis in the NHS and the lifting of restrictions across society. Increased clarity of communication is essential.

  See https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Furl6570.hra.nhs.uk%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbY4p2cs0q4NdWpcHGUDaoQGEWEdRCKxEsdZxCx1v4-2BKKkLWpDIzM-2FLEBg1aCLiUZ0QwdirO98kUSxyz1mJTgwkrGgnr4zUYQhLpwic4DkprVq0pN_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YL0be8xhITsQ-2F6nO4wF9iybE464lOQmVL9BjL3cOsnldhzXCav0q6Co9BdLtCWKMFm39PHJHbFv27NpWEClCS-2FmsxH1XM7tdvPQ3rG8OA0Uu-2F-2Bk-2BQIt1wYRKu1hTEmeb0nxJC3Ok9onNLK9XoaQ4Jr5fRSqQrXLfOjNT5dNkmBQ4A-3D-3D&data=04%7C01%7Capprovals%40hra.nhs.uk%7C36c6856eedd04a59582108da07858021%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637830567204858557%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=A4HluSUjkYnXY52aFMOW%2F3wslARKmV%2B8c%2Bu9VaX0Q7o%3D&reserved=0

• REC name

  N/A

• REC reference

  N/A