When pandemic and everyday ethics collide: supporting ethical decision-making in maternity care and paediatrics during the Covid-19 pandemic

Lead Research Organisation: University of Liverpool
Department Name: Public Health and Policy

Abstract

The response to Covid 19 (C19) will have far reaching consequences for the NHS. This project focuses on how this response has created significant ethical issues for providers of non-C19 services when deciding how to prioritise and reconfigure services.

Our central aim is to evaluate and support ethical decision-making in two non-C19 areas: maternity and paediatrics.

We have chosen these areas because they have been significantly affected by the C19 response, with professional and patient organisations highlighting the problematic effects on both areas (First 1001 Days, Royal College of Midwives, Make Births Better).

Objectives
1. Conduct a rapid review of current local policies and policy-making processes for non-C19 maternity and paediatric services.
2. Examine how the policies are applied in clinical practice and pilot test approaches to ethics support.
3. Make recommendations for ethics support at local policy-making and practitioner levels; and develop tools to support good decision-making practice.

This inter-disciplinary project is an empirically informed ethical analysis of current policies, processes and practice in non-C19 maternity and paediatrics.

Design: empirical ethics, employing Frith's symbiotic empirical ethics approach, where philosophical theory is used to explore the data, draw normative conclusions, and make policy and practice recommendations.

Methods: rapid review of local policies and decision-making processes; analysis (against the national ethics framework for pandemics) of the values being engaged; interviews with key stakeholders involved in policy formation, and healthcare practitioners to understand how the policies are being applied in clinical practice and what support they might need in their ethical decision-making.

Publications

10 25 50
 
Description Prof. Heather Draper gave the Hoffenberg Lecture to the British Transplant Society's Winter Ethics Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Prof. Heather Draper gave the Hoffenberg Lecture to the British Transplant Society's Winter Ethics Symposium (which will also be available to the main British Transplant Society meeting). Heather's lecture was entitled, 'Transplant Ethics and the pandemic legacy'.
Year(s) Of Engagement Activity 2020
URL https://bts.org.uk/events-meetings/upcoming-bts-events/
 
Description Blog for Journal of Medical Ethics 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Blog post looking beyond the initial Covid tsunami and reviewing the ethical challenges in balancing public health and the ongoing health needs of individuals and their families as NHS services are reset
Year(s) Of Engagement Activity 2020
URL https://blogs.bmj.com/medical-ethics/2020/10/30/beyond-the-initial-covid-tsunami-reviewing-the-ethic...
 
Description Blog for Socio-Legal studies association 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Blog post considering ethical decision-making in the 'reset' phase of the pandemic - specifically considering how to support ethical decision-making in non-Covid Health Services
Year(s) Of Engagement Activity 2020
URL http://slsablog.co.uk/blog/blog-posts/reset-ethics-supporting-ethical-decision-making-in-non-covid-h...
 
Description Presentation of a paper 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Prof. Heather Draper gave a paper to a clinical ethics training conference at University Hospital Coventry. The paper was entitled, 'duty to work during the covid 19 pandemic'
Year(s) Of Engagement Activity 2020
 
Description Presentation to Alder Hey Children's NHS Foundation Trust ethics committee 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Presentation to ethics committee at NHS Trust targeted as potential host site for the study
Year(s) Of Engagement Activity 2020
 
Description Presentation to ethics advisory group of Birmingham Women's and Children's NHS Foundation Trust 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Presentation to ethics advisory group intended to support recruitment of Birmingham Women's and Children's NHS Foundation Trust as a host site for the study
Year(s) Of Engagement Activity 2020
 
Description Presentation to international bioethics conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation to a paper session "Looking Forward/Looking Back: Law, Ethics, and Policy in the Age of COVID-19" taking place on 3-4th December, 2020
Year(s) Of Engagement Activity 2020
URL https://aabhl.org