ObjectivesDecisions with an ethical component have been controversial during the COVID-19 pandemic, whether leaked intensive care unit (ICU)-rationing documents, transfer of people to care-homes to ‘protect the National Health Service’ or the duty to treat patients despite inadequate personal protective equipment. To counter criticism of ethics per se, and to help those planning ethics support we describe the practical work of a children’s hospital bioethics team in supporting children, families and clinicians during this unprecedented period.Design/settingThree phases of activity: (i) preparation: we composed several documents to support/guide hospital teams and, together with colleagues, provided them to regional inpatient, community and hospice settings. We adapted existing mechanisms to combat workforce moral injury; (ii) activity (March–June 2020): was highest in our rapid response service where children/families consider difficult treatment decisions with medical teams. Education provided ‘pandemic webcasts’ on decision-making and broader child-health concerns. Staff support was essential, especially for those deployed to overwhelmed local adult ICUs. Research ascertained young people’s views on the pandemic; (iii) reflection: focussed on (a) research about future re-deployment to adult services and minimisation of moral distress/injury, (b) remote video-conferencing—parents’/participants’ experience/ability to consider complex ethical issues and (c) role of faith/non-faith in society’s recovery and children’s views.Main outcome/conclusionsOur bioethics team’s role during the pandemic included: case reviews via video-conferencing, many involving innovative therapy for severely unwell children with COVID-19/Paediatric-Inflammatory-Multisystem Syndrome-Temporally associated with SARS-CoV-2 together with their parents; processes to protect healthcare staff from moral harm and research/educational activity focused on paediatric-specific ethical arising during the pandemic.
interactions and teaching have improved as new elements have been added to these days, and with exposure and practice in this new way of working. Recommendations The Graduate Team found interactions and reflections from learners are more readily offered up where there are a variety of ways to present these, rather than solely having to speak on camera to their teacher and peers, and would recommended incorporating these into virtual learning programmes.
interactions and teaching have improved as new elements have been added to these days, and with exposure and practice in this new way of working. Recommendations The Graduate Team found interactions and reflections from learners are more readily offered up where there are a variety of ways to present these, rather than solely having to speak on camera to their teacher and peers, and would recommended incorporating these into virtual learning programmes.
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