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Original research
Ethical uncertainty and COVID-19: exploring the lived experiences of senior physicians at a major medical centre
  1. Ruaim Muaygil1,
  2. Raniah Aldekhyyel1,
  3. Lemmese AlWatban2,
  4. Lyan Almana3,
  5. Rana F Almana4,
  6. Mazin Barry5,6
  1. 1 Department of Medical Education, The College of Medicine, King Saud University, Riyadh, Saudi Arabia
  2. 2 Department of Family and Community Medicine, The College of Medicine, King Saud University, Riyadh, Saudi Arabia
  3. 3 The College of Medicine, King Saud University, Riyadh, Saudi Arabia
  4. 4 Department of Pediatrics, King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia
  5. 5 Infectious Diseases Unit, Department of Internal Medicine, The College of Medicine, King Saud University, Riyadh, Saudi Arabia
  6. 6 Division of Infectious Diseases, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  1. Correspondence to Dr Ruaim Muaygil, Medical Education, King Saud University College of Medicine, Riyadh 11472, Saudi Arabia; rmuaygil{at}ksu.edu.sa

Abstract

Given the wide-reaching and detrimental impact of COVID-19, its strain on healthcare resources, and the urgent need for—sometimes forced—public health interventions, thorough examination of the ethical issues brought to light by the pandemic is especially warranted. This paper aims to identify some of the complex moral dilemmas faced by senior physicians at a major medical centre in Saudi Arabia, in an effort to gain a better understanding of how they navigated ethical uncertainty during a time of crisis. This qualitative study uses a semistructured interview approach and reports the findings of 16 interviews. The study finds that participants were motivated by a profession-based moral obligation to provide care during the toughest and most uncertain times of the pandemic. Although participants described significant moral dilemmas during their practice, very few identified challenges as ethical in nature, and in turn, none sought formal ethics support. Rather, participants took on the burden of resolving ethical challenges themselves—whenever possible—rationalising oft fraught decisions by likening their experiences to wartime action or by minimising attention to the moral. In capturing these accounts, this paper ultimately contemplates what moral lessons can, and must be, learnt from this experience.

  • COVID-19
  • Clinical Ethics

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/jme-2022-108369

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information.

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    Footnotes

    • Twitter @RuaimM

    • Contributors The authors all contributed to the conception and design of this work. MB and RM shared in data collection, LyA and RF transcribed and translated the collected data. RM, RA and LeA contributed to data analysis. RM, RA, LeA, and MB shared in writing the final manuscript. All authors agreed to the final version of this manuscript. As guarantor, RM accepts full responsibility for the finished work and/or conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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