AMAV VICDOC SUMMER 2023 - Magazine - Page 21
O
n 5 March 2021, Amnesty International
announced that at least 17,000 healthcare
workers globally have died from COVID-19
over the last year, forcing doctors both in
Australia and around the world to confront the very
real question of whether they are willing (or should be
expected) to put their own lives at risk to treat real or
potential COVID-19 patients.
The AMA’s Position Statement on Ethical
Considerations for Medical Practitioners in Disaster
Response 2014, currently under review by the Ethics
and Medico-Legal Committee (EMLC), briefly
addresses doctors’ risk of personal harm when
responding to a disaster.
The position statement affirms that doctors
must balance their duties to individual patients with
their duties to protect themselves, other patients,
staff, colleagues and the wider public from harm,
highlighting that during ‘ordinary’ clinical practice,
these duties do not generally come into conflict, but
during a disaster, tensions between these duties may
very well eventuate.
The current pandemic has turned this potential
eventuality into a stark reality for many doctors in
Australia and worldwide. Medical professionals must
weigh up their duty to treat individual patients infected
with COVID-19 with their duty to ensure they do not
develop COVID-19 themselves and become unable to
work or risk infecting other patients, staff or those in
the wider community.
In addition to the professional duty to reduce risk
of personal harm, doctors also have their own personal
duties and interests in not becoming infected and
risking sickness or even death, or spreading the virus to
their own family members and friends.
So what level of risk of personal harm should
doctors accept? While there is a general expectation
within the community that doctors will accept a
certain amount of personal risk when responding to
a disaster, this risk is not unconditional or without
reasonable limit. The current position statement says
that doctors are entitled to protect themselves from
harm and should not be expected to exceed the bounds
of ‘reasonable’ personal risk.
But the global pandemic has made it clear that
‘reasonable’ risk is highly subjective and the level of risk
that governments, employers, patients and their family
members and others expect doctors to accept when
responding to a disaster may not be ‘reasonable’ to the
medical profession or to individual doctors or their
loved ones.
Globally, professional regulators and associations set
varying standards regarding the expectations of doctors
in relation to risk of personal harm when responding
to disasters.
For example, the Medical Board’s Good Medical
Practice states that:
Treating patients in emergencies requires doctors to
consider a range of issues, in addition to the patient’s
best care. Good medical practice involves offering
assistance in an emergency that takes account of
your own safety, your skills, the availability of other
options and the impact on any other patients under
your care; and continuing to provide that assistance
until your services are no longer required.
The UK’s General Medical Council is more explicit
in its own Good Medical Practice, stating that:
You must not deny treatment to patients because
their medical condition may put you at risk. If a
patient poses a risk to your health or safety, you
should take all available steps to minimise the risk
before providing treatment or making other suitable
alternative arrangements for providing treatment.
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