Coronavirus: can we combine urgency and ethics?



“Emotion sometimes takes precedence over reflection”

Pierre Le Coz, philosopher, professor of philosophy of medicine and member of the ethical space of the Paca region

“There is no such thing as an“ ethical SOS ”and that’s good! Ethics do not adapt well to urgency. It is a time dedicated to reflection, a process of working out moral dilemmas that requires calm, serenity. In acute episodes, emotions tend to take precedence over the reflective process. Ethics aims to catch their breath, to meet the demands of reason, in a spirit of cooperation.

Around the discussion table, the word circulates within the care team; it sets in motion a dialectic between sensitivity and rationality. In times of emergency, we stop thinking to immerse ourselves in action. We rely on standards and apply protocols. We saw it in the spring of 2020, as soon as the Head of State declared that we were ” in war “.

→ REPORT. Covid-19: ethical reflection in healthcare facilities shaken up by the epidemic

When it’s war, there is no time to think, we must obey. Any ethical approach to explaining conflicts of values ​​is swept away by procedures. However, this logic of efficiency has its limits and its paradoxes. Patients are protected but no longer have the right to speak. There is collateral damage from which caregivers also suffer. Nursing home residents find themselves isolated, people die without their families … And ethics in all of this? It is inserted, apart from an emergency, between two critical moments. “

“Yes, and it is essential”

Fabrice Gzil, philosopher at the Île-de-France ethical space, in charge of networks

“At first glance, emergency and crisis situations seem to leave little room for ethics. Some people have thus estimated in the spring of 2020 that the time was not for reflection but for action, that the moment of ethics would come secondly. But it is precisely in times of crisis that ethical reflection is necessary, essential! This assumes that ethics know how to reinvent itself and be innovative in its methods.

Coronavirus: in nursing homes, visits under surveillance

Working groups, surveys, videoconferences on sensitive subjects… We have tried to follow the issues in real time. The audience we met shows that these initiatives were expected. Ethics does not consist in taking the place of those who must make the decisions but in allowing, even in an emergency situation, a sharing of questions. We must also provide benchmarks. In this way, decisions can be more considered, more assumed.

→ PODCAST. “At Mulhouse hospital, I listen to the fears and prayers of Covid-19 patients”

Urgency is, fortunately, not incompatible with attention to the meaning and purpose of acts and decisions! We had already worked on the H1N1 pandemic in 2009. This allowed us not to start from nothing and quickly bring consistent elements for reflection. All of these lessons can be useful in the post-crisis period, for the long term. “

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