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Review Article | Open Access2021|Volume 3|Issue 1| https://doi.org/10.37191/Mapsci-2582-4937-2(2)-018

Coronavirus and Medical Ethics

ReceivedMay 6, 2021RevisedMay 31, 2021AcceptedJun 8, 2021PublishedJul 9, 2021

Meghmala Waghmode1, Neha Patil1, Jaspal Kaur Oberoi2* and Tooba Momin2

1Department of Microbiology, PDEA’s Annasaheb Magar Mahavidyalaya, Hadapsar, Pune, India

2Department of Microbiology, Abeda Inamdar Senior College, KB Hidayatullah Road, Camp, Pune, India

*Corresponding Author: Oberoi JK, Department of Microbiology, Abeda Inamdar Senior College, KB Hidayatullah Road, Camp, Pune, India

Accepted Date: 08-06-2021; Published Date: 09-07-2021

Copyright© 2021 by Oberoi JK. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Medical ethics has been followed in most nations for decades. But during COVID 19 pandemic situation, again every nation has to deal with the ethics related to categorizing patients and health care distribution while maintaining community health. To solve the dilemma of consequentialist and non-consequentialist theories, the major focus was driven on community health. But while looking at the rate of infected, cured, and death, it’s an alarming sign to India to strengthen the medical resources and follow the common good approach. Every Indian citizen has the right to get proper treatment and funerals after death. Considering the problem associated with the spreading of the virus through dead bodies, cremation was done by medical staff. Due to the limited availability of medical staff and lack of an electric furnace, many dead bodies were cremated after a long time. Due to inadequate medical professionals and technical constraints, the infectivity rate is increasing which is affecting the economy, mental strength, and social values. Hence, now we have to start thinking and working on strengthening hospitals, diagnostic labs, and sophisticated cremation centers to avoid negligence and to follow ethics.

Keywords

Consequentialist; Triage Ethics; Corona; Medical Ethics; Covid-19 

Introduction

COVID-19 outbreak due to the infection of the novel coronavirus, SARS-CoV-2 has attacked countless individuals in more than 173 countries and territories worldwide [1].

COVID-19 pandemic again raises questions about the ethics related to the medical profession. Concerns are associated with antibiotic stewardship, false lab report, ventilator availability, awareness program, and cremation of bodies. Prognostic theories suggested by French surgeon Dominique Jean Larry, are suitable during this pandemic situation. These theories are

1. Death after treatment

2. Possibility of survival without treatment

3. Requisite of treatment for survival.

Medical sorting protocols have been based on the above categorical theories. Triage ethics deals with prioritizing prospective patients by setting some rules. Triage decisions are dependent upon the availability of insufficient resources like staff, medicine and, space [2]. In the COVID-19 pandemic situation, major limiting resources were beds, ventilators, PPE kits, testing kits, and medicines in India where the population is more.  Medical ethics include the utilitarian approach of consequentialist theory, which suggests that the “best life is one which produces least pain and distress”. Nonconsequentialist theory includes deontological ethics where moral rules are considered [3]. During handling the COVID-19 pandemic, every nation gave importance to the health of the group rather than an individualistic approach. During this pandemic situation, medical ethics were not properly handled in India to avoid outbreaks and to control the infectivity rate. Efforts implemented by government and medical professionals were found to get failed to implement deontological ethics. Inadequacy of testing, treatment, precautionary measures, and most important people awareness, leads to 5.31million infected people and 85,619 death cases on today’s date.  Maharashtra state is on the first rank in the corona cases.

Most of the hospitals were treating patients with the same protocol like giving herbal decoction, protein diet, treatment of Remdesivir for patients on oxygen support, antiviral and antiprotozoal treatment. During treatment, adequacy of dosage i.e.antibiotic stewardship program was not followed. To meet the demand the drugs, sanitizers, face shield and personal protective equipment kit, quality was compromised by most of the suppliers. Some entrepreneurs find this covid19 situation as the opportunity to set business by linking their products with immunity without any scientific proof. 

This situation again dealing with the gap between the availability of medical resources and population. For every nation, to handle any pandemic conditions, triage ethics and equity ethics are important [2]. Equitable distribution of health care delivery has to be implemented to handle such crises and to maintain community health.

Issues related to handling dead bodies and their respectful funeral

Ethical treatment is not only related to an individual who is alive but after the death of the patient, cremation has to be carried out as per the ritual within a short time. During the cremation process, regional and ecological issues are primarily concerned. Corpses will be the possible sources of viruses, hence instead of burying; cremation in the electric furnaces was the preferred choice among people. In some religions, the burial process has been followed to respect the dead soul and as a memory repository.

Guidelines

Agency

Reference

·         Give highest priority to staff handling dead bodies, by implementing forensic best practices.

·         Maintain the dignity of the dignity of deceased and their relatives.

·         Proper documentation has to be created and maintained.

·         Safety precautions has to be implemented during postmortem of suspicious death.

WHO

[4,5]

·         Precautions for body handlers:

·         Wear (Filtering face piece) FFP3 masks or N95 respirators.

·         Disinfect hands,equipment.

·         Avoid contact with eyes and face.

·         Shoe protection is needed.

International Committee of the Red Cross (ICRC)

[6]

Rules for Importation of Human Remains into the United States for Burial, Entombment, or Cremation

CDC

[7]

Table 1: Describes the fundamental principles for the ethical management of dead bodies.

Discussion

Issues in forensic testing: In previous days, the forensic investigation was done on the crime scenes with some precautions as there was no threat of transmission of the virus from biological samples. 

Centers for Disease Control and Prevention (CDC) suggested rules during this pandemic situation for handling body fluids like respiratory droplets, blood, etc.[8]. Every crime scene has been recommended to consider it as a ‘Hot zone’ [9].

Conclusion

Currently, India is facing lots of ethical issues while handling this COVID-19 pandemic situation. From the beginning, medical ethics were not properly implemented by all the stakeholders. Control over this condition can be achieved by following triage and equity of care. Every nation has to implement the knowledge about medical ethics to all the citizens to handle community health.

References

1. https://www.ersnet.org/covid-19-blog/ethics-in-the-time-of-corona

2. Komrad MS. Medical ethics in the time of COVID-19. Curr Psychiatry. 2020;19(7):29-32,46.

3. Alexander L, Moore M. Deontological ethics. In: Zalta EN, ed. Stanford encyclopedia of philosophy.2020.

4. World Health Organization, Infection Prevention and Control during HealthCare when Novel Coronavirus (nCoV) Infection Is Suspected (Interim Guidance),2020. Geneva.

5. World Health Organization, Infection Prevention and Control for the SafeManagement of a Dead Body in the Context of COVID-19, Interim guidance),Geneva, 2020.

6. O. Finegan, et al., International committee of the red cross (ICRC): general guidancefor the management of the dead related to COVID-19, Forensic Sci. Int. Synergy(2020). Google Scholar | PubMed

7. CDC, What Law Enforcement Personnel Need to Know About Coronavirus Disease2019 (COVID-19), Center for Disease Control and Prevention, 2020.

8. Kowalske Z. Crime scene investigations during COVID-19, Forensic Magazine,2020.


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