In Depth

Ebola: should doctors be forced to treat infected patients?

The risk of Ebola transmission raises an ethical dilemma as some say medics are duty-bound to provide care

The Ebola outbreak is forcing the global medical community to consider the "previously unthinkable"; withholding emergency treatment from infected patients.

Due to the risk of transmission, some hospitals in the US are currently reviewing their policies on the treatment of patients with the virus, Reuters reports. The risk became apparent after two nurses were infected while caring for a patient in Texas.

This comes as nurses in Canada are told they will face disciplinary action if they refuse to treat a patient with Ebola, according to the Canadian Broadcasting Corporation

In the UK, even though healthcare workers "may be anxious "about treating patients with Ebola, they are duty-bound to do so, according to the MDU, the country's leading medical defence organisation.

The treatments being discussed in the US debate could be life-saving but are often invasive. They includes CPR, inserting breathing tubes and dialysis. "To have a blanket refusal to offer these procedures is not ethically acceptable," said Dr G Kevin Donovan, director of the bioethics centre at Georgetown University in Washington.

Dr Nancy Kass, a bioethicist at Johns Hopkins Bloomberg School of Public Health, argues that as long as healthcare workers are provided with adequate protection, they should have to treat the patient.

But others say that such measures go beyond a healthcare worker's professional obligations and they should have the right to refuse to offer treatment, as it would put them at risk.

"The idea that a doctor would stick to his post during an epidemic, that's not part of the Hippocratic Oath," says medical historian Dr Howard Markel. "If you feel your life is at risk you don't have to stay and provide care."

Laurence McCullough, a clinical ethicist at Baylor College of Medicine says the issue "reminds us that there are justified limits on the risk to health and life that health care professionals are expected to take in the care of patients".

Rushing into a quarantined hospital room to administer such treatment could cause lapses in safety procedures, some argue, saying it would be both unsafe and impractical. "To provide timely resuscitation, hospitals would need staff workers suited in protective gear around the clock," argues Lawrence Altman in the New York Times.

Regardless of what each healthcare system decides, policies must be put in place beforehand, warns Dr Fins, chief of medical ethics at Weill Cornell Medical College. "Confronting this problem in the heat of a cardiac arrest is not the right time to be thinking about it."

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