oa Wits Journal of Clinical Medicine - Clinical ethical challenges in the Covid-19 crisis in South Africa

Volume 2 Number Si1
  • ISSN : 2618-0189
  • E-ISSN: 2618-0197



In a recent paper, the USA-based Hastings Center, which addresses social and ethical issues in health care, science and technology, observes that in public health emergencies a shift needs to take place away from the ethical norms of standard clinical practice, which is patient-centred and responsive to individual patient preferences, towards public health ethics, which is concerned with safeguarding the health of the population by means of the best use of resources. This can entail limiting individual rights and choices. They assert that “public health emergencies may feature tragically limited resources that are insufficient to save lives that under normal conditions could be saved”. This necessitates decisions about how to allocate limited resources: “In a public health emergency featuring severe respiratory illness, triage decisions may have to be made about level of care …; initiation of life-sustaining treatment …; withdrawal of life-sustaining treatment; and referral to palliative … care if life-sustaining treatment will not be initiated or is withdrawn”.

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