• Zoë Fritz, Julian L Huppert, Kathleen Liddell, Richard Holton, and Jonathan P Fuld.
• The Healthcare Improvement Studies (THIS) Institute, Cambridge, UK and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK Zbmf2@cam.ac.uk.
• Clin Med (Lond). 2021 Mar 1; 21 (2): e122e125e122-e125.

AbstractThere is an urgent need for an ethical framework to help us address the local and national challenges that we face as clinicians during the COVID-19 pandemic. We propose four key commitments from which a practical and consistent ethical approach can be derived. These commitments are to articulate the needs, rights and interests of the different stakeholders affected by any policy; to be accountable and transparent, recognising that people are autonomous individuals with values and concerns of their own; to consider the impact of our actions on the sustainability of the NHS, infrastructure, service demands and staff welfare; and to treat everybody equitably, with all deserving of consideration and care. Implementing these commitments will require a number of specific actions. We must put in place frameworks enabling clear advocacy for each competing objective; communicate policy and practice effectively to the public; promote integration of decision-making among social, primary, secondary and tertiary care and reduce or stop unnecessary or inefficient interventions; minimise health inequalities; and build spare capacity into the system.In this article, we expand on these actions, and note the legal context in which this would be delivered.© Royal College of Physicians 2021. All rights reserved.

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