Clinical and ethical challenges for emergency departments during communicable disease outbreaks: Can lessons from Ebola Virus Disease be applied to the COVID‐19 pandemic?

EMA - Emergency Medicine Australasia - Tập 32 Số 3 - Trang 520-524 - 2020
Alex Markwell1,2,3, Rob Mitchell4,5, April L. Wright6, Anthony Brown2,3
1Clinical Senate, Queensland Health, Brisbane, Queensland, Australia
2Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
3School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
4Emergency and Trauma Centre, Alfred Hospital, Melbourne, Victoria, Australia
5School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
6Business School, The University of Queensland, Brisbane, Queensland, Australia

Tóm tắt

AbstractEDs fulfil a frontline function during public health emergencies (PHEs) and will play a pivotal role during the COVID‐19 pandemic. This perspective article draws on qualitative data from a longitudinal, ethnographic study of an Australian tertiary ED to illustrate the clinical and ethical challenges faced by EDs during PHEs. Interview data collected during the 2014 Ebola Virus Disease PHE of International Concern suggest that ED clinicians have a strong sense of professional responsibility, but this can be compromised by increased visibility of risk and sub‐optimal engagement from hospital managers and public health authorities. The study exposes the tension between a healthcare worker's right to protection and a duty to provide treatment. Given the narrow window of opportunity to prepare for a surge of COVID‐19 presentations, there is an immediate need to reflect and learn from previous experiences. To maintain the confidence of ED clinicians, and minimise the risk of moral injury, hospital and public health authorities must urgently develop processes to support ethical healthcare delivery and ensure adequate resourcing of EDs.

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EMA - Emergency Medicine Australasia

Tập 32 Số 3

520-524

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