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22 May 2020

Clear and transparent guidelines are needed to protect medics and the most vulnerable during a pandemic

We need clear and transparent guidelines during a pandemic if we are going to protect our doctors and society’s most vulnerable, says bioethicist, Dr Silvia Camporesi. She argues the Global South has a lot to teach us about the balancing act of ethics in health and healthcare.

Doctor wearing protective mask

Italy, for example, was not used to making decisions around prioritisation in health, explains Dr Camporesi in the latest WORLD: we got this in conversation episode with A&E doctor and Bioethics & Society master’s student, Caitlin Gardiner.

The media in Italy argued that doctors should not have to make such decisions when it comes to choosing the provision of care.

Meanwhile, hospitals were trying their best to flatten the curve with limited resources, highlights Dr Camporesi from the Department of Global Health & Social Medicine, who has been in northern Italy since the beginning of the lockdown.

“We had doctors having been reported as weeping in the hallways of the hospital because they had to make this decision.”

Whereas in the South Africa, where Caitlin is originally from, there is a constant balancing act of ethics and the Global North should be learning from this.

“Even before COVID, we have such a high extent of TB and HIV and Aids in South Africa that [triaging has become] just ordinary, morbidly ordinary,” says Caitlin.

Nonetheless, Caitlin agrees that it shouldn’t be the sole responsibility of a doctor to choose how to manage one patient’s life over another’s.

“No one can cope with that and be effective in their job I think, and so this is why bioethics, and having bioethical teams and hospital ethical teams, is so important to make these decisions.”

To flatten the curve and not overwhelm their healthcare systems, governments are restricting individual freedoms for the public good. They both argue that bioethics is also needed when devising these lockdown policies.

“The public health guidelines would say that there should be the best evidence possible support of these restrictions,” says Dr Camporesi.

“So, is it the case [in Italy] that if you go out for a walk or run you are going to contribute to the spreading of the coronavirus?”

She would argue that this is not justified by the current evidence.

However, in South Africa, where the lockdown has been even stricter, Caitlin feels the policies in place may have been needed.

“We have a hugely vulnerable population which in itself causes problems with restricting movement,” says Caitlin.

“However, I think that the limitation of the freedoms that South Africa has imposed has been to prevent a disaster that would completely eclipse all of those things, which would be to decimate our health system.”

Listen to more about bioethics and the trade-offs of the pandemic response on the WORLD: we got this in conversation episode.

In this story

Silvia Camporesi

Visiting Professor in Bioethics