The COVID-19 pandemic resulted in unprecedented restrictions, shutdowns, and stress sources for families and individuals globally. Other than overcoming the uncertainties people encountered when the pandemic struck, parents and guardians also had the added task of caring for their children’s all-round well-being. Most parents could not meet the dual needs they needed to juggle, such as working at home and looking after the children due to the school and daycare services’ closure. More impacts on the family included high unemployment due to layoffs, economic meltdown, reduction in social support, and a reduction in accessing critical community, clinical, and sporting activities, including playgrounds. Nonetheless, some families considered it a bonding time, primarily those without the preexisting risk factors such as worrying about finances or mental health, and some thrived by spending time together. While some families benefited from the pandemic’s family restrictions, most had negative experiences resulting from the restrictions on daily life, combining work and childcare, which were justified because the overall aim was achieved: ending the virus’s spread.
Ethical theories and the dilemma
Deontology and utilitarianism would have different views on the COVID-19 dilemma, with deontology supporting the advantages of family restrictions and utilitarianism opposing it. Individuals emphasize engaging in the ethical theory of decision-making they see as most important to solving their dilemma and that which leads them to the most correct resolution. The theory means that a person will follow the rules towards others in society because it is ethically right to uphold their duty. A common example of the deontological approach is following the law. Moreover, the benefits and drawbacks of deontology support the necessity of restrictions during the pandemic because the suffering is for the greater good of being lawful.
While families would face negative consequences such as juggling between working from home, caring for their children, and catering to all their needs, it was their duty per deontology to follow the law. They must follow the restrictions because the law requires them to do so, even if they do not understand the reasons. Masks, social distancing, and sanitizers effectively reduced infections (Goniewicz & Khorram-Manesh, 2021). However, when the government imposed regulations to stay home and avoid social gatherings, they followed them, even if they suffered for choosing to do so. Regardless of any conflict they had regarding the rules, deontology requires them to obey because it is their duty. Hence, deontology considers the welfare of others as a result of the decisions they are supposed to make.
Conversely, utilitarianism is based on people’s ability to predict an action’s consequences, and the choice that benefits them most becomes the most ethically correct. Utilitarianism is categorized into rule and act, whereby in the latter, one engages in acts that will benefit most people, regardless of laws and personal feelings (Chonko, 2020). For example, because most people suffer from the negative consequences of family restrictions, policymakers may decide to lift the ban on social interactions, allowing children to visit the nearest playgrounds. Inversely, rule utilitarianism focuses more on the law and justice, intending to benefit most people fairly. Hence, rule utilitarianism considers fairness and the law because the one practicing it aims for the majority’s benefit using the most just means. Markedly, due to the high number of parents and children suffering emotionally and psychologically, most would benefit from the ban being lifted, regardless of the consequences. To counter utilitarianism, invoking it may have negative consequences because no one can be certain that their prediction and actions will have the best outcomes. For example, lifting the restrictions against families remaining enclosed would have made them happier, and the pandemic would have continued to spread. Hence, deontology shows that, while people suffered, it was temporary and aided in preventing the disease’s spread.
Two bioethical principles
In this case, beneficence and respect for autonomy are conflicted because one supports people’s freedom while the other restricts it. Beneficence guides the decision-maker to do what is good and right, and the priority becomes the solution to the dilemma. Beneficence also relates to the utility principle, which stipulates that people should generate the largest good over evil ratio (Chonko, 2020). Thus, beneficence requires all ethical theories to achieve the most good because it has substantial benefits. Therefore, based on the case presented, family restrictions were necessary to prevent the spread of the virus. Globally, the set standards, such as wearing masks, sanitizing, and social distancing, were ineffective because the virus was still highly contagious. Restricting movement by keeping people at their homes helped prevent more infections and was instrumental in helping stop the pandemic. Since beneficence requires achieving the most good, the restrictions were necessary for the good of the world regardless of the discomfort they faced.
Respect for autonomy states that ethical dilemma-solving situations should focus on allowing people to make decisions applying to their individual lives. The principle requires people to control their lives as much as they want because they control their chosen lifestyles. Moreover, the principle also emphasizes respecting people’s decisions, emotions, motivations, and capabilities because they understand themselves intimately (Chonko, 2020). Therefore, during the pandemic, people were required to follow the set regulations because each one making a separate decision on the action to take regarding their safety would lead to the virus’s further spreading. They would avoid situations that made them uncomfortable, such as spending all day locked together at home. Nonetheless, respecting their decisions would have unprecedented consequences due to resuming contact, making beneficence the most relatable principle to the negative outcomes of the pandemic.
Relevant College of Nurses of Ontario (CNO) standards
The CNO standards offer a framework for practicing nurses, providing many aspects of healthcare delivery. The CNO standards have six principles, but those most relevant to the case are working together to promote the well-being of patients, providing competent and safe care, and working respectfully with their colleagues to meet patients’ needs (Seabrook, 2023). For example, pandemic planning is a best practice, and nurses are crucial to determining how the facility and its nursing staff respond to emergencies. Restricting interactions among families did not apply to nurses because they were needed in hospitals to mitigate the rising hospital cases. They could also make house calls for patients who fell ill at home and could not access hospital treatment. Nurses also act as role models and follow all the health directives, keeping patients safe. When patient safety is compromised, they collaborate to determine the necessary learning needs and skills they require to maintain competence.
Legal considerations
Restricting family movement during the pandemic has legal considerations that show its advantages and disadvantages, including The Regulated Health Professions Act (RHPA) and human rights. The RHPA defines consistent rules and processes for self-regulation, discipline, governance, and law-making authority (Scheer, 2023). It also develops regulations for responsibility in various healthcare procedures and services. Also called the reserved acts, the healthcare practices occur while providing competent services. The professionals must have the experience, desire, and knowledge necessary to perform healthcare acts. Hence, during the pandemic, nurses were equipped with the skills necessary to care for patients with high infection rates without contagion. However, restricting the movement of families abused human rights such as freedom from torture, opinion and expression, work, and education (Rahman et al., 2021). During the pandemic, people were restricted from attending work and school. They were also tortured with physical and mental issues due to staying too long at home and the lack of an opinion and expression regarding how they felt about the lockdown. Hence, citizens are legally entitled to lawsuits about their freedom of expression.
Overall, some families were comfortable with the restrictions requiring them to stay home during the pandemic. However, most had negative experiences resulting from the restrictions on daily life, combining work and childcare. Based on the utilitarian and autonomy perspectives, the restriction was unnecessary because it was not according to fairness and justice. At the same time, deontology and beneficence justify it because it is morally right to make a decision that benefits everyone. Nurses also required skills such as competence and expertise in caring for patients during the pandemic, but it was unlawful to restrict them because it interfered with their freedom of work, education, and expression.
References
Chonko, L. (2020). Ethical theories. Retrieved [14th October 2020] from https://dsef.org/wp-content/uploads/2012/07/EthicalTheories.pdf
Goniewicz, K., & Khorram-Manesh, A. (2021). Maintaining Social Distancing during the COVID-19 Outbreak. Social Sciences, 10(1), 14. https://www.mdpi.com/2076-0760/10/1/14/pdf
Rahman, M., Ahmed, R., Moitra, M., Damschroder, L., Brownson, R., Chorpita, B., … & Kumar, M. (2021). Mental distress and human rights violations during COVID-19: a rapid review of the evidence informing rights, mental health needs, and public policy around vulnerable populations. Frontiers in psychiatry, 11, 603875. https://www.frontiersin.org/articles/10.3389/fpsyt.2020.603875/full
Scheer, K. A. (2023). Producing law and governance: Disciplinary practices in the Colleges for Doctors and Nurses (Doctoral dissertation, University of Toronto (Canada). https://tspace.library.utoronto.ca/bitstream/1807/130469/2/Scheer_Kerri_Ann_202311_PhD_thesis.pdf
Seabrook, E. M. (2023). A Search for Role Clarity: A Critical Discourse Analysis of the RN and RPN Entry-to-Practice Competencies That Shape Nursing Curriculum in Ontario, Canada. https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=11987&context=etd
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