A new study conducted by Duke Health researchers found that the unique circumstances of the pandemic altered the long-held idea that doctors would provide care regardless of personal risk.
The study found that doctors now have a growing acceptance to withholding care because of personal safety concerns. That's a shift in mentality that was not experienced in the wake of other infectious disease outbreaks such as HIV and SARS.
"All the papers throughout history have shown that physicians broadly believed they should treat infectious disease patients," said the study's lead author, Braylee Grisel, a fourth-year student at Duke University School of Medicine. "We figured our study would show the same thing, so we were really surprised when we found that COVID-19 was so different than all these other outbreaks."
The researchers looked through hundreds of published studies that looked at thousands of sources. Those studies all looked at the ethical dilemma of treating infectious disease outbreaks over the past 40 years.
About 75% of the sources advocated for the obligation to treat sick patients, but sources about COVID-19 had the highest percentage (60%) of sources suggesting it was ethically OK to refuse to treat patients.
Grisel and her co-authors argued that labor rights and workers' protections were the chief reasons cited in the sources arguing that it was OK to not treat sick patients during the COVID-19 pandemic. Another often-cited reason was the risk of infection posted to doctors and their families.
"Some of these results may be because we had the unique opportunity to evaluate changing ethics while the pandemic was actively ongoing, as COVID-19 was the first modern outbreak to put a significant number of frontline providers at personal risk in the United States due to its respiratory transmission," said senior author Krista Haines, D.O., assistant professor in the departments of Surgery and Population Health Sciences at Duke University School of Medicine.