Are clinicians obligated to treat highly infectious patients? Bioethics experts discuss

The recent Ebola outbreak in West Africa raised an interesting question in medicine: Are clinicians obligated to treat patients who have highly infectious diseases? Bioethics experts from Johns Hopkins discussed the topic in a piece published in Disaster Medicine and Public Health Preparedness.

"Clinicians face a moral predicament of choosing between their trained instinct to treat all patients and the real fear of spreading infection by taking extreme and/or invasive measures that may pose little chance of saving an Ebola patient's life," said Cynda Rushton, one of the co-authors of the article.

The American Nurses Association's position statement asserts that sometimes nurses do not have to treat such patients, when "the risks of harm may outweigh a nurse's moral obligation or duty to care for a given patient."

The authors of the Disaster Medicine and Public Health Preparedness piece stress that data will be "essential" to separate facts of the disease and the fears associated with it.

Additionally, hospitals and health systems should make it very clear to clinicians what they are expected to do. "Institutions have an obligation to disclose their expectations of clinicians, make explicit the processes and protocols that govern practice, outline their scope of commitment to clinicians who become infected and articulate the consequences to clinicians for failure to fulfill their expected duties," the article states.

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