Ethical Dilemmas for Health Workers in the Period of Covid-19: Kenya's Experience

Abstract

Ethics is a system of moral principles. They affect how people make decisions and lead their lives. Adilemma situation in which a difficult choice has to be made between two different things.  Health care workers have a duty to care for their patients as well as their colleagues, families and the community. This duo responsibility is faced with tough challenges which the health care workers have to make decisions about. These challenges range from their profession, the environment they are working in and the patients.   In Kenya, the first person to test positive for COVID-19 was reported on 13^th March 2020.  COVID -19 is a highly infectious disease that is known to spread very fast than the capacity of the health care system in Kenya can absorb. These two major characteristics (highly infectious and fast spreading) poses ethical dilemmas for the health care workers who are on the frontline in its management. Tough decisions such as whether to treat of not for fear of infection, which patient should be given priority against others, whether to disclose patients' information and resources allocation have to be made. The health care workers have to strike a balance between their professional code of conduct and the Ministry of Health guidelines in the management of the pandemic. The objective of this paper was to discuss the ethical dilemmas facing health care workers in Kenya in the wake of Corona Virus Pandemic. While there are many ethical issues in health care service delivery, this study focused on four areas: professional responsibility, prioritizing of screening and testing, confidentiality and allocation of resources. The study employed a desktop approach where secondary information was searched from books, journals articles and online sources.  The study established that health care workers in Kenya are guided by codes of conduct for the different ranks in the health care delivery system.  While it is the duty of the healthcare workers to manage the patients under their care, the study stabled that with COVID-19 and its nature, there are certain conditions to be fulfilled such as availability of appropriate personal protective equipment.  The study also established that the status of persons testing positive for COVID-19 was disclosed due to public interest.  The study also notes that there exists a criterion for prioritizing screening and testing for COVID- 19. Availability of resources, both soft and hard resources was noted to be a great challenge. Kenya health care system lacks critical care equipment such as ICU beds, oxygen and ventilators. In conclusion the many challenging ethical, social, economic and legal issues around the management of COVID-19 Pandemic in Kenya invites decision and policy makers and the entire society to re-examine the fundamental assumptions and foundation in the country's current health care system. This is because COVID-19 Pandemic has caused a ‘new normal' and to fit in this new dispensation Kenya needs to re-engineer and intervene in her health care system.