SARS and Health Care Workers' Duty
- Yujin Nagasawa
Eubios Journal of Asian and International Bioethics 13 (2003), 208.
Philosophy Program, Research School of Social Sciences
Australian National University, Canberra, ACT 0200
In the July 2003 issue of EJAIB James Dwyer, in
discussing what we have learned from the experience of SARS, contends that the
SARS outbreak tested various aspects of our ability to respond to new
infectious diseases. While I agree with most of what he says, I have a
reservation on one specific point.
Dwyer claims that one of the most important
things that SARS tested is the duty of health care workers to treat. He points
out that while most health care workers lived up to their professional duty,
some doctors and nurses in Taiwan were reported to have stayed away from work
or even resigned their positions.
It seems obvious that health care workers are
not justified in giving up their professional duty to treat patients in an
ordinary situation. However, it is less obvious that they are not justified in
giving up their professional duty in any situation.
In the case of SARS an ethically challenging
question is, as Dwyer says, whether health care workers had a professional duty
to go to work, stay involved, and treat patients of SARS even at some risk to
themselves. He answers to this question as follows: "I think the answer is a
qualified yes. Like firefighters and police officers, health care workers
implicitly agree to accept a reasonable level of risk when they enter their
I think it is far from clear that the answer
should be a yes, even if it is a qualified yes. For in order for the answer to
be positive the following two assumptions, both of which seem to me to be quite
controversial, must be made:
(1) Health care workers have a professional duty to treat patients
even at some risk to themselves because they implicitly agree to accept a
reasonable level of risk when they enter their profession.
(2) SARS placed health care workers at only a reasonable level of
First, it is not clear that health care workers
universally agree to accept a reasonable risk when they enter their profession.
Normally, health care workers do not need to expect serious risk in their work,
particularly compared with firefighters and police officers. If, as Dwyer says,
it really is agreed that they have a professional duty to treat patients
at some risk to themselves, then it is unfortunate that the agreement is only implicit.
Second, it is far from clear that SARS placed
health care workers at only a reasonable level of risk. The facts appear
to show otherwise. At the beginning of the outbreak, more than 1/4 of the
people who became infected, and more than 1/5 of the people who died, were
health care workers.
It is at least very difficult to determine
whether health care workers really do have a professional duty and moral
obligation to treat people with highly infectious and fast-spreading diseases,
when it is obvious that their own lives are at risk.
Go back to EJAIB 13 (6) November 2003
Go back to EJAIB
The Eubios Ethics Institute is on the world wide web of Internet: