• Alexandra M Dunham, Travis N Rieder, and Casey J Humbyrd.
• From the Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine (Dr. Dunham and Dr. Humbyrd), and The Johns Hopkins University, Berman Institute of Bioethics (Dr. Rieder and Dr. Humbyrd), Baltimore MD.
• J Am Acad Orthop Surg. 2020 Jun 1; 28 (11): 471-476.

AbstractThe Coronavirus disease 2019 pandemic has been an unprecedented challenge to healthcare systems and clinicians around the globe. As the virus has spread, critical questions arose about how to best deliver health care in emergency situations where material and personnel resources become scarce. Clinicians who excel at caring for the individual patient at the bedside are now being reoriented into a system where they are being asked to see the collective public as their responsibility. As such, the clinical ethics that clinicians are accustomed to practicing are being modified by a framework of public health ethics defined by the presence of a global pandemic. There are many unknowns about Coronavirus disease 2019, which makes it difficult to provide consistent recommendations and guidelines that uniformly apply to all situations. This lack of consensus leads to the clinicians' confusion and distress. Real-life dilemmas about how to allocate resources and provide care in hotspot cities make explicit the need for careful ethical analysis, but the need runs far deeper than that; even when not trading some lives against others, the responsibilities of both individual clinicians and the broader healthcare system are changing in the face of this crisis.

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