Challenges for medical students in applying ethical principles to allocate life-saving medical devices during the COVID-19 pandemic: a qualitative study.

Publication date: Dec 03, 2023

The emergence of the COVID-19 pandemic has posed a significant ethical dilemma in the allocation of scarce, life-saving medical equipment to critically ill patients. It remains uncertain whether medical students are equipped to navigate this complex ethical process. To assess the ability and confidence of medical students to apply principles of medical ethics in allocating critical medical devices through the scenario of virtual patients. The study recruited third- and fourth-year medical students during clinical rotation. We facilitated interactions between medical students and virtual patients experiencing respiratory failure due to COVID-19 infection. We assessed the students’ ability to ethically allocate life-saving resources. Subsequently, we analyzed their written reports using thematic analysis to identify the ethical principles guiding their decision-making. We enrolled a cohort of 67 out of 71 medical students with its mean age of 34 and 60 percent of them were female students for this study. Seventy-three percent of them cited the principle of justice while analyzing this scenario. A majority of them expressed hesitancy in determining which patient should receive life-saving resources, with 46% citing the principle of non-maleficence, 31% advocating for a first-come-first-serve approach, and 25% emphasizing respect for patient autonomy as key influencers in their decisions. Notably, medical students exhibited a lack of confidence in making ethical decisions concerning the distribution of medical resources. A minority, comprising 12%, proposed the exploration of legal alternatives, while 4% suggested medical guidelines and collective decision-making as potential substitutes for individual ethical choices to alleviate the stress associated with personal decision-making. The study highlights the importance of improving ethical reasoning under time constraints using virtual platforms. More than seventy percent of medical students identified justice as the predominant principle in allocating limited medical resources to critically ill patients. However, they exhibited a lack of confidence in making ethical determinations and leaned toward principles such as non-maleficence, patient autonomy, adherence to legal and medical standards, and collective decision-making to mitigate the pressure associated with such decisions.

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Concepts Keywords
Covid Confidence
Ethics Covid
Pandemic Decision
Seventy Ethical
Students Life
Making
Patient
Patients
Percent
Principle
Principles
Resources
Saving
Students
Virtual

Semantics

Type Source Name
disease MESH COVID-19 pandemic
disease MESH critically ill
disease IDO process
disease MESH respiratory failure
disease MESH infection
disease VO LACK
disease VO time
disease VO document
disease VO ProHIBiT
drug DRUGBANK Methylphenidate
disease MESH death
drug DRUGBANK Coenzyme M
drug DRUGBANK Aspartame
disease VO effectiveness
disease VO device
disease MESH pneumonitis
disease MESH multiple chronic illnesses
disease IDO country

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