Combating COVID-19 Pandemic in Nepal: Ethical Challenges in an Outbreak

Shah, Aarati; Aacharya, Ramesh Prasad

doi:10.31729/jnma.4959

Cited by 9 publications

(23 citation statements)

References 19 publications

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“…The rapid and serious outbreak of this pandemic has resulted in urgent responses for detecting and diagnosing patients, treating and managing their care, and combating further contamination. 1 Positioned at the front lines of the fight against the disease, healthcare providers are at increased risk of infection for themselves, their families, and other people with whom they come into contact. As a result, they may choose or be forced to maintain isolation from their families during this period.…”

Section: Introductionmentioning

confidence: 99%

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

2020

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Background: Positioned at the frontlines of the battle against COVID-19 disease, nurses are at increased risk of contraction, yet as they feel obligated to provide care, they also experience ethical pressure. Research question and objectives: The study examined how Israeli nurses respond to ethical dilemmas and tension during the COVID-19 outbreak, and to what extent this is associated with their perceived risk and motivation to provide care? Research design: The study implemented a descriptive correlative study using a 53-section online questionnaire, including 4 open-ended questions. Participants and research context: The questionnaire was complete by 231 registered and intern nurses after being posted on nurses’ Facebook and WhatsApp groups, and through snowball sampling. Ethical considerations: The research was pre-approved by the ethics committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa, Israel. Findings: In all, 68.8% of the respondents had received some form of training about COVID-19. Respondents positioned themselves at perceived high risk levels for contracting the virus. About one-third feared going to work because of potential contraction and due to feeling inadequately protected. While 40.9% were scared to care for COVID-19 patients, 74.7% did not believe they have the right to refuse to treat certain patients. When asked about defining an age limit for providing patients with scarce resources (such as ventilation machines) in cases of insufficient supplies, respondents stated that the maximum age in such scenarios should be 84 (standard deviation (SD = 19) – yet most respondents (81.4%) believed that every patient has the right to receive optimal treatment, regardless of their age and medical background. Discussion: Correlating with their strong commitment to care, nurses did not convey intention to leave the profession despite their stress, perceived risk, and feelings of insufficient support and protection at work. The nurses did not hold a utilitarian approach to resource allocation, thereby acknowledging the value of all people and their entitlement to care, regardless of optimal outcomes. Conclusion: While experiencing significant personal risk and emotional burden, nurses conveyed strong dedication to providing care, and did not regret working in the nursing profession, yet they did seek a supportive climate for their needs and ethical concerns.

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Section: Introductionmentioning

confidence: 99%

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

2020

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“…The COVID-19 pandemic has led to complex and unpredictable conditions in every country’s health system [ 5 ]. The disease symptoms are changing, and their severity has increased periodically, adding to the challenges faced by healthcare providers, who are striving to protect their own health and the health of the community [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Nurses’ experiences during the COVID-19 pandemic in Iran: a qualitative study

et al. 2021

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Background Nurses are at the forefront of patient care during infectious disease pandemics and they play a key role in treating and preventing the upward trend of the disease. Hence, it is crucial to consider their experiences in designing action plans to combat coronavirus disease 2019 (COVID-19). Since there is not enough data in this regard, the current study aimed to investigate the nurses’ experiences in caring for patients with COVID-19 in Iran. Methods In this descriptive qualitative study, a total of 20 nurses were selected by purposive sampling. Semi-structured interviews were conducted and analyzed using qualitative content analysis to collect data. Results Data analysis revealed four main themes, including ‘duality in the form of care,’ ‘confusion and ambiguity in care planning’, ‘workload’, and ‘social isolation in spite of positive image.’ Conclusion Our findings indicated that the nurses experienced a range of paradoxes during the COVID-19 pandemic; these paradoxes included distraction from providing care due to focus on marginal factors in spite of empathy and cooperation in nurses, the presence of volunteer support staff despite the lack of equipment, lack of scientific information and the unreliability of online information, overload in the hospital due to insufficient facilities and equipment, and the physical avoidance of people in the community in spite of social support for nurses in the media. The results of this study can lead to a clear understanding for managers and healthcare policymakers in the country and aid them in taking optimal measures to support nurses and improve the quality of nursing care against COVID-19.

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“…Reflection articles were the most common design (94.44%) (2,(4)(5)(6)(8)(9)(10)(11)(13)(14)(15)(16)(21)(22)(23)(24)(25) , followed by descriptive qualitative studies (5.56%) (26) . Most articles were published in English (94.74%) (2,(4)(5)(6)(9)(10)(11)(13)(14)(15)(24)(25)(26) , in journals from the medical (55.60%) (2,4,8,11,(13)(14)(15)(16)22,25) , ethical (33.30%) (5)(6)10,21,24,26) , and public health fields (11.10%) (9,23) . The BVS was the portal with the highest number of articles (73.68%) (2,…”

Section: Resultsmentioning

confidence: 99%

“…They also took measures to screen for contacts and isolate people with suspected or confirmed cases of the disease. They made an attempt to contain the propagation of the virus (1,4) , minimizing morbimortality indexes and reducing the overload of health systems (1,(4)(5)(6) .…”

Section: Introductionmentioning

confidence: 99%

Decision making by health professionals during COVID-19: an integrative review

et al. 2022

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Objective: To analyze the scientific production on the decision making of health workers during the COVID-19 pandemic. Methods: Integrative review in the databases CINAHL, MEDLINE, Scopus, ScienceDirect, WoS, and BVS. Inclusion criteria: original articles available in full, in any language, related to the object investigated. Results: During this pandemic, health workers have been making decisions based on ethical/bioethical principles (utility, beneficence, non-maleficence, autonomy, justice, proportionality, flexibility, clinical prognosis, duration of the need, and fair health attention), values (solidarity, equality, equity, utilitarianism, relational autonomy, reliability, reciprocity, maximization of the benefits and resources, and prioritization of those in worse conditions), beliefs and personal motivation, protocols, directives, tools, algorithms, recommendations, and criteria. Final considerations: Decision making has never been so necessary as in this pandemic. This article is not a recipe for the professionals, since decision making is based on numerous factors. However, it provides them with a foundation that can be helpful in this difficult process.

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Combating COVID-19 Pandemic in Nepal: Ethical Challenges in an Outbreak

Cited by 9 publications

References 19 publications

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

Nurses’ experiences during the COVID-19 pandemic in Iran: a qualitative study

Decision making by health professionals during COVID-19: an integrative review

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