Background
Normally, physicians understand they have a duty to treat patients, and they perform accordingly consistent with codes of medical practice, standards of care, and inner moral motivation. In the case of COVID-19 pandemic in a developing country such as Bangladesh, however, the fact is that some physicians decline either to report for duty or to treat patients presenting with COVID-19 symptoms. At issue ethically is whether such medical practitioners are to be automatically disciplined for dereliction of duty and gross negligence; or, on the contrary, such physicians may legitimately claim a professional right of autonomous judgment, on the basis of which professional right they may justifiably decline to treat patients.
Methods
This ethical issue is examined with a view to providing some guidance and recommendations, insofar as the conditions of medical practice in an under-resourced country such as Bangladesh are vastly different from medical practice in an industrialized nation such as the USA. The concept of moral dilemma as discussed by philosopher Michael Shaw Perry and philosopher Immanuel Kant’s views on moral appeal to “emergency” are considered pertinent to sorting through the moral conundrum of medical care during pandemic.
Results
Our analysis allows for conditional physician discretion in the decision to treat COVID-19 patients, i.e., in the absence of personal protective equipment (PPE) combined with claim of duty to family. Physicians are nonetheless expected to provide a minimum of initial clinical assessment and stabilization of a patient before initiating transfer of a patient to a “designated” COVID-19 hospital. The latter is to be done in coordination with the national center control room that can assure admission of a patient to a referral hospital prior to ambulance transport.
Conclusions
The presence of a moral dilemma (i.e., conflict of obligations) in the pandemic situation of clinical care requires institutional authorities to exercise tolerance of individual physician moral decision about the duty to care. Hospital or government authority should respond to such decisions without introducing immediate sanction, such as suspension from all clinical duties or termination of licensure, and instead arrange for alternative clinical duties consistent with routine medical care.
Computer software is a unique technological advancement which creates enormous possibilities, but also raises complex moral probler?zs. In one way, these moral problems are not entirely new in character; rather a new dimension of traditional moral dilemmas. On the other, we are not ready yet to tackle them with traditional nzoral norms andprinciples. Several new normative guidelines are required for computer technology related issues, such as, privacy, property rights, internet control, conJidentiality, cyber harm, and cyber risk. More importantly, software ownership right, a right which is absent in traditional ethical discussions, is necessacv to protect. However, as software is a completely new creative work, traditional legal framework (e.g. copy right, patent, and trade secrecy laws) and philosophical ownership theories (e.g. labour theory, utilitarian theory) are inappropriate to protect the right of software owner or its inventor: A lack of effective ownership laws, inadequate ethical principles as well as traditional philosophical grounding have created policy vacuum in computer software property rights.
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