Which Ethical Principles Guided the Ethical Decision During the COVID-19 Pandemic in the UK, Ireland, and the US? Findings from a Qualitative Systematic Reviews

Abstract

Introduction:

With the Covid-19 pandemic impacting the world at such a quick rate and with many unknown variables and dangers, there was an immediate need for ethical guidance to ensure those in many different healthcare settings such as researchers and other professionals could perform ethically in this new and complex situation. This study aims to take existing research on those ethical guidance documents in the UK/Ireland and compare them with those from the United States.

Method:

This study used a qualitative systematic review methodology with thematic synthesis to analyze the included ethics-related guidance documents, as defined in this review, published in the UK and Ireland between March 2020 and March 2022. The search included a general search in Google Scholar and a targeted search on the websites of the relevant professional bodies and public health authorities in the three countries. The ethical principles in these documents were analyzed using the constant comparative method (CCM).

Results:

In the UK and ROI review, 44 guidance documents met the inclusion and exclusion criteria, and 11 main ethical principles were identified, which were then categorized under two main themes: respect and duty. The 11 main ethical principles were: fairness, honesty, minimizing harm, proportionality, responsibility, autonomy, respect, informed decision-making, community, the duty of care and reciprocity.

In the US review, 270 documents were found from searching several public health United States government bodies. Of these documents, 50 were deemed to be Covid-19 ethical guidance, each ethical principle was tallied from every document and compared with the results from the UK/Ireland study.

Conclusion:

There were remarkable similarities in some ethical principles prioritized in the Covid-19 pandemic ethical guidelines across the Atlantic Ocean. However, there were differences in the interpretations and frequencies in which these principles were used across different regions.