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Exploring the Perspectives of Local Health Workers on Ethical Tensions Experienced during Epidemic Outbreaks in Under-Resourced Settings

Abstract

Introduction:

The outbreak of virulent epidemics like SARS, Ebola Virus Disease and COVID-19, have devastating consequences on populations and healthcare systems. One of these consequences is the exposure of health workers to the contagions. This leads to ethical tensions about their duty of care to patients and concerns about personal safety and other responsibilities. Although some studies have considered measures to assist health workers deal with ethical tensions during public health crises, most of these projects were undertaken in High-Income Country settings where the healthcare system is robust. There is therefore the need for studies to explore the perspectives, constraints and opportunities of health workers in under-resourced settings like Liberia during health crisis like the Ebola epidemic and COVID-19 pandemic.

Objectives:

a) identify the ethical tensions that confronted Liberian frontline health workers during Ebola crisis and currently COVID-19 and characterize them in the “early,” “peak” and “denouement” phases of the outbreaks, b) understand the meaning of “duty” from the perspective of a frontline health worker in Liberia, including a duty to patient, family, colleagues and self.

Method:

An empirical bioethical inquiry involving a) a scoping review that will adopt Arksey and O’Malley’s guidelines b) a qualitative study that will employ interpretive description methodology and c) a normative ethical analysis of findings of qualitative research.

Expected Outcome:

a) Offer a rich account of how Liberian health workers in deprived health facilities navigated through ethical tensions during the Ebola epidemic and currently COVID-19 pandemic, b) highlight Liberian health workers viewpoints on weak healthcare systems, personal safety and duty of care during health crises

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