Abstract
This questionnaire-based observational study was conducted in July 2020 with the aim of understanding the ethical and social issues faced by health care providers (HCPs) registered with the Japanese Society of Intensive Care Medicine in intensive care units (ICUs) during the coronavirus disease (COVID-19) pandemic. There were 200 questionnaire respondents, and we analyzed the responses of 189 members who had been involved in COVID-19 treatment in ICUs. The ethical and social issues that HCPs recognized during the pandemic were difficulties in the decision-making process with patients’ families, limitations of life-sustaining treatment, lack of palliative care, and inadequate mental support for patients’ families and HCPs. Regarding decision-making on issues of clinical ethics during the pandemic, more than half of the respondents thought they had failed to provide sufficient palliative care to patients and responded that they experienced moral distress. The free-text responses on moral distress revealed issues such as unusual treatment and care, restricted visits, challenging situations for HCPs, and psychological burden. Additionally, 38.1% of respondents experienced episodes of social prejudice or discrimination and 4.7% experienced a shortage of medical resources. Our study result shows that the moral distress of HCPs was caused by difficulties in patient-centered decision-making and insufficient medical care to patients and their families. These were caused mainly by a lack of communication due to the stronger implementation of infection control measures. We believe that it is important to address ethical and social issues during a pandemic in order to provide appropriate medical care and prevent burnout among HCPs.
Highlights
The COVID-19 outbreak, which was first reported in China, advanced rapidly worldwide and was officially declared a pandemic by the World Health Organization on March 11, 2020 (Mannelli 2020; WHO 2020)
The medical resources that were in shortage included personal protective equipment (PPE) required for medical procedures (70.9%), nurses (45.0%), physicians (33.3%), and intensive care units (ICUs) beds (28.0%). This questionnaire-based study investigated the ethical and social issues encountered in Japanese ICUs and how these changed during the COVID-19 pandemic
This study provided insight into the ethical and social issues encountered in Japanese ICUs during the COVID-19 pandemic
Summary
The COVID-19 outbreak, which was first reported in China, advanced rapidly worldwide and was officially declared a pandemic by the World Health Organization on March 11, 2020 (Mannelli 2020; WHO 2020). In Japan, a state of emergency was declared for the first time on April 7, 2020, owing to the spread of COVID-19 mainly in urban areas. Infection control measures, such as refraining from going out, closing schools, testing for COVID-19, and isolating those who tested positive, were implemented. During the initial phase of the pandemic, the number of seriously ill patients was lower in Japan than in other countries, facilities accepting critically ill COVID-19 patients were limited because of a lack of adequate infection control measures and equipment shortages.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
