Medical professionalism in times of COVID-19 pandemic: is economic logic trumping medical ethics?
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CE - LETTER TO THE EDITOR
Medical professionalism in times of COVID‑19 pandemic: is economic logic trumping medical ethics? Marko Ćurković1,2 · Andro Košec2,3 · Danijela Ćurković4 Received: 30 May 2020 / Accepted: 10 July 2020 © Società Italiana di Medicina Interna (SIMI) 2020
Keywords COVID-19 · Pandemic · Medical professionalism · Bioethics · Allocation of resources Dear Editor, Medical professionalism faced a crisis of identity prior to the current COVID-19 pandemic, with unresolved issues of conflict of interest and notions emphasizing professional and academic misconduct dominating its discourse [1]. Declining trust among all stakeholders emphasized the need for professional accountability and integrity while encouraging control by external agents, logics and mechanisms [1]. In response, medical professionals committed to stewardship and just distribution of finite resources and provision of high value, cost-conscious care. To meet these challenging issues, medical professionals need to examine their roles and responsibilities above and beyond their “office”, serving as an immediate actor of change and improvement in health care systems. However, the ongoing pandemic setting exposed the tragic limits of such professional aspirations. The COVID-19 pandemic caused a temporary global collapse, and an ongoing severe disturbance of health care systems by creating a surge of demand for all forms of medical care that cannot be adequately and safely addressed. In response, comprehensive and restrictive public health measures were applied that continue to exert deleterious * Marko Ćurković [email protected]; marko.curkovic@bolnica‑vrapce.hr 1
University Psychiatric Hospital Vrapce, Bolnicka Cesta 32, 10000 Zagreb, Croatia
2
School of Medicine, University of Zagreb, Salata 2, 10000 Zagreb, Croatia
3
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre Milosrdnice, Vinogradska Cesta 29, 10000 Zagreb, Croatia
4
Department of Dermatology and Venereology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
side effects [2, 3]. Issues regarding (re)allocation of scarce health care resources are omnipresent, with medical professionals not only struggling to tackle the virus, but also reducing availability and level of care for all other patients, raising inherent ethical problems of equality and equity. The pandemic created the complex matrix of personal, professional and societal demands and obligations for medical professionals, while their abilities to care for their own health and safety and of their patients’ are profoundly undermined. Medical professionals are being pressed to provide care outside the limits of their professional expertise, often being forced to make previously unimaginable and unprecedented choices, such as to choose whom and when they should allocate lifesaving treatments [3]. One should not be mistaken that these issues concern only those on the “front lines”. These efforts were not unnoticed by the public, a c
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