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    Balancing health worker well-being and duty to care: an ethical approach to staff safety in COVID-19 and beyond.

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    Author
    McDougall, RJ; Gillam, L; Ko, D; Holmes, I; Delany, C
    Date
    2020-09-25
    Source Title
    Journal of Medical Ethics
    Publisher
    BMJ
    University of Melbourne Author/s
    Gillam, Lynn; McDougall, Rosalind; Delany, Clare
    Affiliation
    Medical Education
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    McDougall, R. J., Gillam, L., Ko, D., Holmes, I. & Delany, C. (2020). Balancing health worker well-being and duty to care: an ethical approach to staff safety in COVID-19 and beyond.. J Med Ethics, pp.medethics-2020-106557-. https://doi.org/10.1136/medethics-2020-106557.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254608
    DOI
    10.1136/medethics-2020-106557
    Open Access URL
    https://europepmc.org/articles/PMC7520818?pdf=render
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520818
    Abstract
    The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment (PPE) in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-being. We describe each of these values, and present a decision-making framework that integrates the two. The aim of the framework is to guide the process of balancing these two values when staff safety is at stake, by facilitating ethical reflection and/or decision-making that is systematic, specific and transparent. It provides a structure for individual reflection, collaborative staff discussion, and decision-making by those responsible for teams, departments and other groups of healthcare staff. Overall the framework guides the decision maker to characterise the degree of risk to staff, articulate feasible options for staff protection in that specific setting and identify the option that ensures any decrease in patient care is proportionate to the increase in staff well-being. It applies specifically to issues of PPE in COVID-19, and also has potential to assist decision makers in other situations involving protection of healthcare staff.

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