COVID-19 pandemic: ethical and legal aspects of inadequate quantity and quality of personal protective equipment for resuscitation
- Patrick Wong1, Wan Yen Lim2, Huei Leng Chee2, Rehana Iqbal3
- Received July 10, 2020 Revised August 10, 2020 Accepted August 24, 2020
- NOTES
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Author Contributions
Patrick Wong (Conceptualization; Data curation; Supervision; Validation; Writing – original draft; Writing – review & editing)
Wan Yen Lim (Data curation; Writing – original draft; Writing – review & editing)
Huei Leng Chee (Writing – review & editing)
Rehana Iqbal (Validation; Writing – review & editing)
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Table 1.
Healthcare worker’s rights | |
World Health Organization, Interim guidance (2020)* | Allow health workers the right to remove themselves from a work situation if they have a reasonable justification to believe that it presents an imminent and serious danger to their lives or health. |
European Resuscitation Council “COVID-19 Guidelines” (2020)† | Resuscitation should not be started or continued in cases where the safety of the provider cannot be sufficiently assured. |
General Medical Council (UK) “COVID-19 Questions and Answers” (2020)‡ | If a patient poses a risk to the health workers’ health or safety, they should take all available steps to minimize the risk before providing treatment or making other suitable alternative arrangements for providing treatment. |
Employer’s duty | |
World Health Organization, Interim guidance (2020)* | Ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks. |
Provide adequate infection control and prevention and PPE supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to those caring for suspected or confirmed patients with COVID-19. | |
The Personal Protective Equipment at Work Regulations (1992)§ | Every employer shall ensure that suitable PPE is provided to his employees who may be exposed to a risk to their health or safety while at work except where and to the extent that such risk has been adequately controlled by other means which are equally or more effective. |
*World health organization. Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health. World Health Organization, Interim Guidance. 2020 Mar [2020 Mar 18]. Available from http://www.who.int/publications/i/item/coronavirus-disease-(covid-19)-outbreak-rights-roles-and-responsibilities-of-health-workers-including-key-considerations-for-occupational-safety-and-health,
†European Resuscitation Council. European Resuscitation Council guidelines. 2020 May [2020 May 15]. Available from http://erc.edu/sites/5714e77d5e615861f00f7d18/content_entry5ea884fa4c84867335e4d1ff/5ea8860e4c84867421e4d1e0/files/ERC_covid19_pages_section1.pdf?1588257319,
‡General medical council. Coronavirus disease (COVID-19) Questions and Answers. 2020 May [2020 May 7]. Available from http://www.gmc-uk.org/ethical-guidance/ethical-hub/covid-19-questions-and-answers,
§The Personal Protective Equipment at Work Regulations 1992. 2020 May [2020 May 13]. Available from http://www.legislation.gov.uk/uksi/1992/2966/contents/made?view=plain.
- References
- 1. European Resuscitation Council. European Resuscitation Council COVID-19 Guidelines [Internet]. Niel: ERC; 2020 Apr 24 [cited 2020 May 15]. Available from https://erc.edu/sites/5714e77d5e615861f00f7d18/content_entry5ea884fa4c84867335e4d1ff/5ea8860e4c84867421e4d1e0/files/ERC_covid19_pages_section1.pdf?15882573192. Wong P, Ong SG, Lim WY. COVID-19 and cardiopulmonary resuscitation: an N95 respirator mask may not be adequate. Br J Anaesth 2020; 125: e319-22.
[Article] [PubMed] [PMC]3. Centers for Disease Control and Prevention. The National Institute for Occupational Safety and Health (NIOSH). Recommended guidance for extended use and limited reuse of N95 filtering facepiece respirators in healthcare settings [Internet]. Atlanta: CDC; [updated 2020 Mar 27; cited 2020 May 9]. Available from https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html4. Song W, Liu Y, Ouyang Y, Chen W, Li M, Xianyu S, et al. Recommendations on cardiopulmonary resuscitation strategy and procedure for novel coronavirus pneumonia. Resuscitation 2020; 152: 52-5.
[Article] [PubMed] [PMC]5. Malm H, May T, Francis LP, Omer SB, Salmon DA, Hood R. Ethics, pandemics, and the duty to treat. Am J Bioeth 2008; 8: 4-19.
[Article]6. Pahlman I, Tohmo H, Gylling H. Pandemic influenza: human rights, ethics and duty to treat. Acta Anaesthesiol Scand 2010; 54: 9-15.
[Article] [PubMed]7. British Medical Association. COVID-19: refusing to treat where PPE is inadequate [Internet]. London: BMA; [updated 2020 Nov 30; cited 2020 May 15]. Available from https://www.bma.org.uk/advice-and-support/covid-19/ppe/covid-19-refusing-to-treat-where-ppe-is-inadequate8. The National Archives. UK Public General Acts. Health and Safety at Work etc. Act 1974 [Internet]. Norwich; [cited 2020 May 15]. Available from https://www.legislation.gov.uk/ukpga/1974/37/contents