What the 'greater good' excludes: Patients left behind by pre-operative COVID-19 screening in an Ethiopian town

Area of Science:

• Public Health
• Bioethics
• Ophthalmology

Background:

• The COVID-19 pandemic prompted bioethical discussions focusing on population health and societal benefit.
• Hospital policies implemented measures like visitor restrictions, protective equipment, and screening to mitigate SARS-CoV-2 transmission.
• These restrictions, while intended for collective safety, disproportionately affected certain communities.

Purpose of the Study:

• To analyze the ethical implications of hospital policies during the COVID-19 pandemic.
• To examine the differential impact of these policies on various societal groups.
• To illustrate these impacts using a case study of an ophthalmological outreach program in Ethiopia.

Main Methods:

• A case study approach was employed, focusing on an ophthalmological unit's outreach program in Ethiopia.
• Analysis of pre-operative screening policies and their consequences.
• Review of bioethical considerations in pandemic-related healthcare policies.

Main Results:

• Pre-operative screening policies, designed for broad protection, negatively affected underserved communities.
• The implementation of universal restrictions overlooked the specific needs and vulnerabilities of different populations.
• The case highlights the tension between population-level safety measures and equitable access to care.

Conclusions:

• Hospital policies during pandemics require a nuanced approach that considers the diverse impacts on all communities.
• Ensuring societal benefit necessitates a holistic review of policies' effects on inequitably positioned groups.
• Ethical healthcare policy in public health crises must balance collective safety with individual and community needs, particularly for vulnerable populations.