Exploring the Ethics of a Nurses' Strike During a Pandemic

Area of Science:

• Medical Ethics
• Public Health Emergencies
• Nursing Professionalism

Background:

• Healthcare workers' refusal to work during mass medical emergencies, particularly over compensation, is generally an ethical violation.
• Work stoppages can compromise patient safety and violate the principle of beneficence.
• Exceptional circumstances may exempt healthcare workers from their obligation to work if personal or familial risks are significant.

Purpose of the Study:

• To assess the moral framework guiding nurses' decisions regarding work stoppages during pandemics.
• To analyze the ethical calculus involved in balancing beneficence towards patients and healthcare workers.
• To incorporate considerations of risk, duration, protective measures, and racial justice into ethical decision-making.

Main Methods:

• Ethical analysis of professional obligations during public health crises.
• Examination of the principle of beneficence in the context of pandemics.
• Consideration of risk-benefit assessments, including short-term and long-term impacts.
• Inclusion of racial justice as a factor in ethical decision-making for healthcare workers of color.

Main Results:

• The ethical decision-making process during pandemics is complex, involving multiple competing obligations.
• Risk assessment must account for present and future patients, healthcare workers, and the duration/severity of risks.
• Disproportionate risks to nurses of color necessitate the inclusion of racial justice in the ethical calculus.
• Protective measures and their availability significantly influence the ethical permissibility of work stoppages.

Conclusions:

• Nurses' ethical obligations during pandemics are not absolute and require a nuanced approach.
• A comprehensive ethical framework must weigh patient welfare against healthcare worker safety and well-being.
• Pandemic-related ethical decisions must consider long-term consequences and address systemic inequities, such as racial disparities in risk exposure.