Mental-health care under threat: a pragmatic approach for ethical decision-making for practitioners in COVID-19

Abstract

It is difficult to overstate the global impact of Coronavirus disease (COVID-19) outbreak. From lockdowns to resource scarcity, the effects of the virus have been widespread and felt by all. Less obvious, but equally severe, is the impact on the practice of psychology. In this time of crisis, complex ethical challenges arise daily in our practice, many of which likely to remain with us for years to come. Thus, there is a pressing need for a pragmatic ethical framework that psychologists can use to navigate the conflicting duties and rapidly changing demands during this time of crisis. To that end, we suggest utilizing the Georgetown principles, four pragmatic ideals developed by biomedical ethicists which can aid clinicians in framing and managing ethical dilemmas. In this work, we show how these principles can be applied to complex ethical conflicts typical of clinical practice in the era of COVID-19. We will discuss ways in which the Georgetown principles are echoed in the Psychologists Code of Conduct, emphasizing items in the Code that are directly relevant to the COVID-19 pandemic. Our goal is to leave the reader with a practical ethical methodology that can be used for quick, effective, and morally sound decision-making. The goal of this paper is not to tell clinicians what decisions they should make; rather, herein we will provide clinicians with tools that will enable them to make ethically-informed decisions on their own.