The Difficult Moral Calculus Facing Healthcare Workers
There have been a number of articles written, including by our CEO, on the approaches healthcare professionals could and should adopt when making decisions about the allocation of scarce resources during crises.
All draw on key philosophical concepts to define what is just. There are a number of lenses through which to view the issues such as utlitiarianism, contractualism, egalitarianism and virtue ethics.
Julian Savulescu, Uehiro chair in practical ethics at University of Oxford, and visiting professorial fellow, Murdoch Children’s Research Institute and Melbourne Law School, and Professor Dominic Wilkinson, consultant neonatologist at John Radcliffe Hospital in Oxford and Professor of Medical Ethics at University of Oxford, suggest in this article five ways in which Australia could consider managing its limited supply of ventilators.
However, as Yascha Mounk, an associate professor at Johns Hopkins University, notes in this article on the Italian response to the crisis, despite “countless hours in fancy seminar rooms discussing abstract moral dilemmas like the so-called trolley problem” he has “not the first clue whether they are recommending the right or the wrong thing.”
“Part of the point of all those discussions was, supposedly, to help professionals make difficult moral choices in real-world circumstances. If you are an overworked nurse battling a novel disease under the most desperate circumstances, and you simply cannot treat everyone, however hard you try, whose life should you save? Despite those years of theory, I must admit that I have no moral judgment to make about the extraordinary document published by those brave Italian doctors.” There are no rules or guidelines which will provide absolute certainty in extraordinary situations. When it comes to the crunch, individuals in leadership positions and on the front line must make the best decisions they can.
All leaders must be prepared to face, at some point, unforeseen and complex challenges. While the current crisis is an extreme example, these are not the times to start thinking about your own personal ethics and convictions. Confidently making decisions at such times requires leaders to already have a strong, well developed ethical framework upon which to build their thinking. For their own benefit, and because, ultimately, the community needs to rely on the judgement of its leaders, and trust that they have our best interests at heart.