Nurses and COVID-19: Ethical Considerations in Pandemic Care

Dr. Connie M. Ulrich is the Lillian S. Brunner Chair in Medical and Surgical Nursing and a Professor of Bioethics and Nursing at the University of Pennsylvania School of Nursing with a secondary appointment in the Perelman School of Medicine, Department of Medical Ethics and Health Policy.  Dr. Ulrich was trained in bioethics at the National Institutes of Health in the Department of Bioethics. Her national and international bioethics program of research has focused on advancing empirical bioethics in both clinical practice and research using innovative mixed methodology approaches.  She has received funding for her work from the National Institutes of Nursing Research, National Cancer Institute, and other federal and state agencies. Dr. Ulrich has published in leading medical, nursing, and bioethics peer-review journals; and has published a book on “Everyday ethics: ethical issues and stress in nursing practice.”  Her most recent book, published by Springer Nature with her colleague Dr. Christine Grady is entitled “Moral distress among the Healthcare Professions.” Dr. Christine Grady is a nurse-bioethicist and a senior investigator who currently serves as the Chief of the Department of Bioethics at the National Institutes of Health Clinical Center. Her research is both conceptual and empirical and primarily in the ethics of clinical research, including informed consent, vulnerability, study design, recruitment, and international research ethics, as well as ethical issues faced by nurses and other health care providers. Dr. Grady has authored more than 175 papers in the biomedical and bioethics literature and authored or edited several books, including The Oxford Textbook of Clinical Research Ethics. She served from 2010-2017 as a Commissioner on the President's Commission for the Study of Bioethical Issues. She is an elected fellow of the Hastings Center and of the American Academy of Nursing, a senior research fellow at the Kennedy Institute of Ethics and an elected member of the National Academy of Medicine. She serves as an attending on the Bioethics Consultation service, an IRB and DSMB member, and a member of several editorial boards.

• Introduction.- Understanding Acceptable Risks in Healthcare [Occupational risks/limits/PPE/obligations].- Finding Compassion: Helping Patients Die and Sometimes Alone.- Preparing to Make Difficult Choices: Triage Decision and Crisis Standards of Care.- The Emotional and Moral Remnants of COVID-19: Burnout, Moral Distress, and Mental Health Concerns.- Unintended Consequences: Lack of Essential and Nonessential Patient Care, Furloughs of HCP, and Institutional Financial Losses.- Lingering and Glaring Health Disparities amidst COVID-19.- School nurses/pediatric concerns. “School Health.- Chapter 9. Global Health Ethics: Nursing Voices from China and Brazil.-Moving Forward: What Have We Learned? Where do we go from here? [Conclusion] (Opportunities to move forward).