Ethical Consequences of the Shift from Deontological Principalism to Utilitarianism in the Context of Medical Care Delivery during the Covid-19 Pandemic
Abstract
The COVID-19 pandemic, which quickly became global, brought with it, in addition to consequences in the form of a large number of infected and dead, also worrying ethical issues. The enormous increase in the number of infected patients in need of pulmonary ventilation or ECMO causes increasing pressure on available resources and, due to the depletion of these resources, means the need for an effective triad of patients.
In an overloaded health system, the doctor must decide which patients will be provided with intensive care and which will not. In principle, this is a question of ethics and distributive justice.
In times of crisis, a utilitarian approach is generally applied, based on the principle of maximizing benefits for as many patients as possible. In times of pandemic, a utilitarian approach seems necessary.
However, for first-line physicians who are forced to perform an effective patient triad, this means a departure from the deontological paradigm that underlies the discreet physician-patient relationship. The decision to provide medical care, given the lack of resources that doctors have to make, entails a moral burden that cannot be ignored.