Researcher examines ethical questions raised during COVID-19 pandemic

Michael Rozier, S.J., Ph.D., professor and department chair for health management and policy at Saint Louis University, has authored a paper examining ethical questions raised during the COVID-19 pandemic and what can be done, to address similar ethical questions in the future.

Rozier and his colleagues published the paper titled "Incorporating Ethics Lessons from the COVID-19 Pandemic into Postpandemic Curricula for Health Administration and Health Policy Students," in The Journal of Health Administration Education.

In the paper, Rozier and his colleagues surveyed areas where health care ethics questions arose during the COVID-19 pandemic, and discussed lessons that can be learned from those questions. These ethical dilemmas were broken into four different categories: clinical, organizational, social and legal. For each of these different areas, Rozier and his colleagues examined problems that publicly rose to the forefront during the COVID-19 pandemic.

"The disparities that arose during the pandemic around infections, hospitalizations and mortality were always there," Rozier said. "The pandemic revealed those disparities in a much clearer way. And so how we address those disparities moving forward in a non-pandemic era is essential. The pandemic also revealed for us the degree to which we're willing to sacrifice in any way for the common good and spurred social negotiations about our core values.

"The pandemic revealed many disparities, but they have always been there and will be there until we actually talk about them."

Clinical questions tackled triage procedures and the allocation of life-saving equipment. Organizational inquiries inspected the role insurance companies played in allowing or denying coverage and explored how hospitals determined how many visitors could see patients and which patients could receive visitors.

Socially, researchers considered what role the general public holds in keeping society healthy. Legal discussions explored what authority the government has to enact public health measures, and, to what extent.

Rozier has seen firsthand how academic discussions about ethics can prepare leaders to lead teams through ethical decision making.

Years before the pandemic began, Rozier and his Saint Louis University colleagues posed similar questions to students as part of the University's health management and policy program. When the pandemic reached American soil, SLU graduates were primed to tackle these ethical questions, putting them on the frontlines against COVID-19.

"I had former students reaching out to me who were in the workforce who told me, 'I'm the only member of our team who actually has thought through these particular issues. I'm in charge of leading the team as we think through all the ethical questions for my health care organization, because no one else was talking about this before the pandemic, and now we have to talk about it,'" Rozier said. "As an institution, that's really encouraging that we're teaching our students to be leaders in their organizations."

When it comes to ethical questions like the ones posed in the paper, Rozier notes that productive discussions aren't necessarily about determining which answers are right or wrong. Rather, it's about thinking critically, creating dialog between those who make decisions, and making informed choices.

"You're never going to get people to be in 100% agreement on any particular issue," Rozier said. "So rather than fixing an ethical issue, I think the best we can do is have a shared understanding of what each one of us prioritizes and how we can agree to move forward together and continue to debate anything that comes up along the way. Ethics is not always about prioritizing a particular value system, but rather being able to look at a complex issue and appreciate the many competing dimensions and realize that you must choose a way forward."

While governments around the world have declared the COVID-19 pandemic over, Rozier knows that the ethical dilemmas raised during the last few years will continue to linger.

"The most important challenge for the future is to educate our future workforce," Rozier said. "It's going to be our nurses, our doctors, our health care managers, all of the people who are our future professionals in this space, who are going to continue to make a difference. We also need to keep the public informed and have thoughtful conversations with each other that come from a place of mutual respect. By doing those things, we can tackle these ethical issues in the future."