The Duty to Care of Healthcare Professionals:
Ethical Issues and Guidelines for Policy Development1
Dianne Godkin, RN PhD
Hazel Markwell, PhD DTh
Submitted to SARS Expert Panel Secretariat
December 22, 2003
1 The opinions expressed herein are those of the authors and do not necessarily reflect those of the
organizations for whom they are employed.
2
Providing care for patients during the SARS crisis placed many healthcare
professionals in a position of significant risk—risk to their health and well-being and risk
to the health and well-being of their family members, friends, and colleagues. Those who
directly cared for individuals suffering from SARS were in the group at the highest risk
of contagion. Even after the introduction of appropriate infection precautions including
personal protective equipment, healthcare providers who participated in invasive
procedures with SARS patients in the context of intensive care, remained susceptible to
the virulent and potentially deadly virus. Many healthcare providers became ill with
SARS; several died. Because of the potential harms associated with contracting SARS, a
number of healthcare professionals in many settings (e.g., inpatient/outpatient, acute
care/long-term care, community) raised questions about their duty to care, with some
ultimately refusing to work. In this discussion paper, the specific issues and concerns that
arose around the notion of a duty to care are identified and described. The underlying
ethical values and value conflicts are examined. We conclude with policy guidelines that
balance the healthcare professionals’ duty to care with a set of reciprocal responsibilities
of government, employers, and healthcare colleagues to healthcare professionals.
Although the proposed policy guidelines were developed in response to the experiences
of healthcare providers during the SARS crisis, they are broad enough to apply in the
context of any public