Coronavirus Presents Unprecedented Moral, Professional Test for Otolaryngologists

How will the salient ethical issues that arise from COVID-19 affect practicing otolaryngologists?

Bottom Line: Pandemic conditions dictate that otolaryngologists limit exposure and maximize benefit and simultaneously uphold their ethos to serve patients in need.

Background: The COVID-19 pandemic has dramatically altered how otolaryngologists can safely and ethically deliver healthcare. Issues related to patient volume, resource utilization, and exposure risk have overridden the basic elements otolaryngologists rely on in daily practice. Practitioners need ways to adjust patient-centered care to accommodate the new public health reality.

Study design: Commentary/literature review.

Setting: Center for Bioethics and Social Sciences in Medicine and Department of Otolaryngology–Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Mich.

Synopsis: Medical ethics for practicing otolaryngologists focus on the primacy of individual patients and the doctor-patient relationship. This significantly differs from public health ethics, which are by necessity population driven. During the COVID-19 pandemic, the overriding need to protect the public means that otolaryngologists must alter patient-focused practices for everyone’s safety. It will be necessary, for example, for clinicians to limit, modify, or delay patient evaluations or treatments that risk aerosolizing virions, and for them to concern themselves with medical supply and equipment rationing. Patients with urgent conditions such as head or neck cancer will present ethical dilemmas to clinicians, who must weigh exposure risks against those of delaying treatment. Despite these circumstances, otolaryngologists can guide and surveil patients via remote contact, contribute ventilators/supplies, and help in less conventional ways during the pandemic, as the history of the medical professional dictates. Clinicians may offer validation and resource provision to aid the psychosocial well-being of patients. Similarly, self-care and self-monitoring is essential for overtaxed clinicians, whose resilience is vital during this challenging time.

Citation: Shuman AG. Navigating the ethics of COVID-19 in otolaryngology [published online ahead of print April 14, 2020]. Otolaryngol Head Neck Surg. doi:10.1177/0194599820920850.