Medical ethics experts identify, address key issues in H1N...(rs. Do HCWs have an obligation to tr...),Health

Do HCWs have an obligation to treat patients despite risk of infection? What limits, if any, are there to health care workers' duty to care? What institutional supports are owed to health care workers in a pandemic?

Important documents such as codes of ethics and professional directives are unclear on the question of acceptable risk for HCWs.

The JCB says 90% of those surveyed believe HCWs should report to work and face all risks provided safety precautions are provided. 85% believe governments should provide HCWs with free disability insurance and death benefits during a flu crisis and 84% think HCWs who feel unsafe at work have a right to file a grievance.

The public, though, was somewhat conflicted on what to do with HCWs who do not come to work without a legitimate reason. Almost half (48%) agree they should face loss of employment or professional license, 38% disagree. The sharpest division appears with respect to the government using conscription of HCWs during a pandemic: 47% agree, 43% disagree.

The research showed strong agreement that health care professionals have an implicit social contract based on their profession and training to provide care under adverse conditions.

The researchers heard from study participants that, "like soldiers, HCWs should be expected to uphold their duties no matter how challenging and frightening the situation. On the other hand, the group also felt that the government and health care organizations had reciprocal obligations to protect health care professionals from elevated risks in all ways possible, including policies to ensure a safe working environment."

The obligation to work is not without qualification, as 89% of survey participants agreed that a serious health problem that could increase flu vulnerability was a legitimate excuse from work.

The public was less supportive of competing care obligations such as young children or elderly re
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