COVID-19 has upended a long-standing belief that physicians must care for infectious disease patients, irrespective of their own personal risk, suggests research published April 24 in Clinical Infectious Diseases.
A team led by researchers at Durham, N.C.-based Duke Health analyzed 187 studies that explored the ethical dilemma physicians face during novel infectious diseases outbreaks, including HIV/AIDS, severe acute respiratory syndrome, COVID-19, Ebola and flu.
About 75% of research suggested physicians have an obligation to treat infectious patients, regardless of personal risks. This mindset was widely seen across papers published from the 1980s up until the COVID-19 pandemic.
"All the papers throughout history have shown that physicians broadly believed they should treat infectious disease patients," lead author Braylee Grisel, a fourth-year student at Duke University School of Medicine, said in a news release. "We figured our study would show the same thing, so we were really surprised when we found that COVID-19 was so different than all these other outbreaks."
Sixty percent of COVID-19 papers suggested it was ethically acceptable for physicians to refuse care — the highest percentage seen for any infectious disease. AIDS had the lowest amount at 13.3%.
Study authors noted physicians faced unique challenges during the pandemic — including resource shortages, misinformation about vaccines and treatments, and increased mistreatment of medical staff — that may have changed the patient-physician relationship.
"This study really shows how outside pressures in the sociopolitical sphere influence and affect doctors and care providers," Ms. Grisel said. "In future pandemics, we may need to become more aware of how the risks and outside pressures of an active pandemic influence willingness to provide care. Health care systems can learn how to mitigate these influences to ensure that hospitals are adequately staffed to meet patient needs."